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11/20/2007 10:17 916-371- -99 RANEY GEOTECHNICI PAGE 01/01 <br /> 11/20/2007 08:24 209464,-,S EI`IVIP.ONMENTAL HEAT .r'. PAGE 97,/91 <br /> DATE RECEIVED EI-11)LOU NUMgGF; <br /> r SAN J4AQLiIN COUNTY(�lD E01 U v F D ENVIRONMENTAL HFALTTi,OFPARTMEN . <br /> COD E:T;t: Main Street, Stockton., CA 95202-2708 <br /> Ivli V ` Q 2��] Telephone: (.209)468-3420 Fax: (209)464.013$WeU: ��ruv. ' av e,220 9 <br /> ENVIRO WENT HEALTH PUBLIC RIECORDS RELEASE APPLICATION <br /> PER L ANT: BU91NE9SIAf3ENGY: it . <br /> ADDRESS* <br /> PHONE(1): !2 1(e <br /> / { /(d, <br /> TENTATIVE'APPOINTMENT DATE- - /� �� Time: 40 0 <br /> - <br /> (Plevae allow 10 business days from Lake of pplicatlon submi I-`TenloNve only•must be conflrme ) <br /> © CHECK BOX TO EXPEDI ST-$R( 00 FE OR CHECK QNLY)-REQUEST PROCESSED IN 3 RUSI ESS DAYS <br /> SIGNATURE OF APPLICANT DAYS <br /> Electronic Inf`0rrnatlon; ❑ Llst❑M p-Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> Strect# Street Name • Clty ❑ Unit 1 <br /> 2. - _ 7oGlc O unit zLZ K Gel <br /> 1 05 14 <br /> l <br /> 4. <br /> Unit 3 <br /> t7. <br /> ___ (, ' ❑ Unit 5 <br /> 4%' <br /> 8. <br /> —...- ❑ Unit G <br /> 10. <br /> Specific Date Range of Information RequeshW:From Ato <br /> ENVIRONMENTAL HEALTH D4PARTMENT FILES <br /> [WUNDERCROUND TANK(UST)CLEANUP SITE(LOP) 0 HOusiNG ARATFMENT D SCUM WASrE FACturylvQHICLE <br /> %OTHER CLEANUP SITE(NON-LOP) 171 F'oOD FACILITY 0 WASTE TIRE <br /> AUNDERGROvND TANN(MCNITOPINGIREMOVAL) ❑DDG KENNLL ❑DAIRY <br /> AHAZAk0OUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TRRATMt:NT PLANT <br /> 0 TIEPiRp PERMITTED FACILITY ❑M0TEI.(HQT6L C1 puMp6RTRUCKlYARD(CNEM'l'OILETa <br /> O TATTQQ(BOOY PIERCING ❑POOLISPA 0 LAMP U$£APPLICATION BITES <br /> *MEDICAL WASTE FACILITY ❑OTNEft(PI-EAS£$P£CIFY) <br /> WmLLANC SEPTIC PERMIT RBOoRdL ARE AYAILASLK FOR RyiEW-MONDAY-FRI DAY 9:H AM-5:00PM -ExcluDING HouoAYs. <br /> 1. List up to ten addresses in the space Above. Select the typefs)of files from the list above by checking the appropriate <br /> box(ec). At loast one file type MUST be selected. Fp= to(209)464.0138 gr mail to the address indicated sbOVe Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will ba processed the next business day. <br /> 2.. The EHD will notify the applicant it any EHA files exist, An appointment for review Will be confirmed approximately ten(10) <br /> days after receipt of applicalfion. The files will be hold for a maximum of five business days for review, Appolntmonft <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available fdr review, A new application may be <br /> submitted when the file Is slvnilable. <br /> 4. Any file not ratumed In the same condition as releasedVII be reorganized by EHO staff at the expense of the opplicant. <br /> Futuna file reviews by the same applicant may requlrq a$98.00 deposit prior to review. <br /> EHrfUSE ONLY <br /> xwri if you should need further assistance please Contact Diene Martinez @ (209}468-3425 directly. Thank You*** <br /> �Q n p,nraaoe <br />