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04/25/2008 09:40 FAX a001/001 <br /> 04/25/2008 09:43 209d6498 ENVIRONMENTAL &TH PAGE 02/02 <br /> DATE RECEIVED EHD LOG NUM <br /> SAN JOAQMN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT 1�qq' <br /> 11 600 East Main.St. Stockton,CA 95202-2708 <br /> APR, Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/elid <br /> I'IJBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; BUSINESSIAGENCY. GY1er-can <br /> ADDRESS: 3434 1 Yl rmo'H Ase I v aw enf-11) M o1s82 1 <br /> PHONE(1)' a1le . 460 02.08 PHONE(2); 111(,P, 444S FACSIMILE:glla • 40o.OU435 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days ham date of application Submittal-'Tentative only-must tw 0=11 med) <br /> ❑ CHECK BOM TO EXPEDITE REQUEST.$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROcEsSED IN 9 AUSINESS DAYS <br /> —s77 SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List El Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street E Street Name _ City ❑ unit 1 <br /> 1. 434 FREsMtj-r ST I- `JTbGKTQNf <br /> 2. y445 f iz~F�IorJT bT_ E Tock ra .l Vo GO, unkx <br /> 3. 4 i NION7 b� L (? uNt3 <br /> 4. <br /> T. C] unit 5 <br /> 10. <br /> Specific Date Range of information Rapuested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> XUNDERGROUNDTANK(UBnCLEANupSrrsILOP) MHouslNGABATEMENT FSouoWASTE FAcILRYNEH10W <br /> OTHER CLQANUP SITE(NONa.OF) OFoOP PAciLRY ❑WASTE TIRE <br /> UNDDRGReuND TANK(MONRORa7Ga2EMWAL) O DOCK MIL O DAIRY <br /> �HAzARDOus WADTEE GENERATOR C2CKICKEN RANCH O WASTEWATEN TREATMENT PLANT <br /> 13 Timm PrRMITIEP FACILITY 0 MOTRIJHOTEL 0 PUMPCR TRUCIUYPRo1CNBM TD1I.ETB <br /> 0 TATTOO)SODYPIEROINa 0 POOUSPA M LAND USE APPLIOATION SITES <br /> 0 MEDICAL WASTE FACILITY M OTHER(PLEAst SPEC01 <br /> WELL ANP SEPTIC PERMIT REOORDS ARE AvNR BLE FOR REVIEW • MONDAYfPoDAY 0700 AMS:DOPM - EXtLUDEIGHOLI)AT% <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es), At least one file type MUST be selected. FaX to(2081 a 4.0136 er mail to the addres indicated above. Address <br /> ranges will not be accepted—for additional assistance with Ella addresses,contact the EHD.Applications raeelvsd 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. Tho files will be held for a maximum of five buslnaas 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 now application may be <br /> submitted when the filo la evoilable. <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 /> •'°`If u need further assistance please contact bions Martlnez ID (209)j68-3425 directly. Thank You" " <br />