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TO'd -1H-L01 • <br /> DATE � tvrl 1 „' ,� SAN JOAQUIN COUNTY V +_ <br /> S L�U l�U ENVIRONMENTAL HYALTH DEPARTMENT <br /> FEB 13 2007 304 Bast Weber Avenue, 3r1 Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/clid <br /> ENVIRON10NIT HEALI H <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 2A I-f)PF L BUSINESSIAGENCY: SNS R <br /> ADDRESS:1QLA01 OLD -FLACC-2.vl LA' RD. SACRAMCPM LA '2E2C Z1 <br /> PHONE(1): 9IIp 2-132) (-11-43?) PHONE(2); '1(tD X02--11Od FACSIMILE: -9110 310Z 25100 <br /> TENTATIVE*APPOINTMENT DATE: /� �ZOb�' Time; �3:30 A" <br /> (Please allow 10 business days from date of application submittal-•rentadvo only-must be confirmed) <br /> © CHECK BOX TO EXPEDITE REQUEST-_05.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ' ` DATE ;Z Q l_- <br /> Electronic Information: '9 List❑ Map-Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street p Street Name C'Ay ❑ Unit 1 <br /> 11- tool E- ._ M I N M AVEN"15 STDcA'-1130 usf <br /> 2. ❑ Unit 2 <br /> 3. <br /> $. .._..... 7q p Unita <br /> 6- Unit 4 <br /> 7. <br /> s. <br /> -- <br /> 3 2001 ❑ Unit 5 <br /> 9. <br /> —._.._.. . ..__. ❑ Unit fi <br /> 10. <br /> Specific Date Range of Information Requested: From qq to ZO 0-1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Cl SOLID WASTE FACILNTIVEHICLE _ <br /> E3 OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY O WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> O TIERED PERmn-nio FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARD/CHEM TOILETS <br /> 0 TATTOOIBODY PIERCING 0 POOL/SPA 0 LANG USE APPLICATION SIMS �y <br /> 0 MEDICAL WASTE FACILITY Cl OTHER(PLEASE SPECIFY) 03 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FR1oAY 5:00 AM-5:00PM - ExcI.UDIN3 HOUDAY$, <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted--for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may he <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> FNIIMM W\Y)fYY <br /> TO/TO'd 00T8 E9£ 9T6 00T8 29£ 9T6 8£:80 LOOS-£T-H3d <br />