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07/25/2007 14:29 510-434,7676 PSI INC PAGE 02/02 DAT �V,6Dv r:. I `p Lr �',,' i�' I! T'1�/ I[-=' LLJ/ SAN JOAQUIN COUNTY EHO LOG NUMBER Lr C. J!_li , ENVIRONMENTAL HEALTH DEPARTME jlJL �, 2gp7 304 East Weber Avenue, : s 09) 4 Stockton, b: 95208 �� Telephone: (209)468-3420 Fax: (209) 464-0138 Web: wwwsagov. g ENVIR011jk'EI'4! HEALDH, to pEfi!;f„?'SERV ICES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: ADDRESS:yJ'�' 1'4'W*Ur AYC 'S(•' VJ BUSINESSIAGENCY: PHONE (1): 510 43`+ 97-00 Ellk 13 PHONE (2): FACSIMILE:J$io 13 11 141 TENTATIVE` APPOINTMENT DATE; Fof(�, hv>r} 11b•_>z Time: (Please allow 10 business deye from da or gppliogtion •ubmiltal •'Tentativa only -must be 25 CHECK BOX TO EXPEDITE REgUES/T -$93.00 FE{€,(C,'ASHAOR CHECK ONLY) • REgUEST PROCESSED IN IN SIGNATURE OF APPLICANT l �F-`� DATE Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES LT UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 17 HOUSING ABATEMENT ❑ SOLID WASTE FACIL( YNEHICLE OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE ;' dNDERGROUND TANK(MONITORINGIREMOVAL) C3 DOG KENNEL ❑DAIRY 'FJIAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT ❑ TOE En PERMITTED FACILITY O MOTEUHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS TATTOOIBODY PIERCING ❑ P000SPA ❑ LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY M OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8;90 AM-S:OOPM - EXCLUDING HOLIDAYS. 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to 1209) 464-0138 or mail to the address indicated above. Address ranges will not be accepted -for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pen will be processed the next business day. 2. The EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file Is available. 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the arr•p•- ,:. Toaenn uy Lim same appucant may require a 383.OU deposit prior to review. END •401406 t/1•p5 FILE ADDRESS Cf111 "MCI (/LPiI� 1 �FF7�Z'wA • a � I . t't a�J�r a�� �I Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES LT UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 17 HOUSING ABATEMENT ❑ SOLID WASTE FACIL( YNEHICLE OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE ;' dNDERGROUND TANK(MONITORINGIREMOVAL) C3 DOG KENNEL ❑DAIRY 'FJIAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT ❑ TOE En PERMITTED FACILITY O MOTEUHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS TATTOOIBODY PIERCING ❑ P000SPA ❑ LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY M OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8;90 AM-S:OOPM - EXCLUDING HOLIDAYS. 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to 1209) 464-0138 or mail to the address indicated above. Address ranges will not be accepted -for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pen will be processed the next business day. 2. The EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file Is available. 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the arr•p•- ,:. Toaenn uy Lim same appucant may require a 383.OU deposit prior to review. END •401406 t/1•p5