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�•��,fifi'�`R�`g1�i��'i I`�i� <br /> SAN JOAQUIN COUNTY EHt)LOG NUMBER <br /> U; C01R11 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> 's olephone: (209)468-3420 Fax: (209)464-0138 Web,. WWW.Sjgov. 110 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> J <br /> APPLICANTIARk 14 ISUMBY BUSINESS/AGENCY: EN TR I X;INC. <br /> ADDRESS: CG�S81Z CHAVi5 *203 CITY/STATEIZIP: -SANTA BAOAMr (A g3ta3 <br /> PHONE(1): �05 -%3---0917 PHONE(2): Std-919-MORS FACSIMILE: 905 943 -- OY/;L <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 bu$I"O&S days from date of application submittal-"Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115 FEE(CASH OR CHECK ONLY) REQUEST PROCESSED IN 3 BUSINESSDAYS <br /> SIGNATURE OF APPLICANT DATE 10 <br /> -10—dronic Information: ❑ List❑ Map--Description: <br /> FILE ADDRESS EMD USE ONLY <br /> Street# Street Name City []unit 1 <br /> Ivn <br /> 2. CPN; 129-QD-'aif ❑ Unit 2 <br /> 3. <br /> 4. <br /> Unit 3 <br /> 6. <br /> Unit <br /> 7. <br /> 8. <br /> 9 Unit 5 <br /> 10, <br /> /Unit6 <br /> Specific Date Range of Information Requested: From Z O to P <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> XuNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT E�fSOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY LJ WASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOUAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH El WASTEWATER TREATMENT PLANT <br /> TIERED PERMrITED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SFPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AFM-5:00pM(EXCLUDING HOLIDAYS) <br /> 1. List up to ton a0dresses 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)4640138 or mall 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 EHO 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 behold 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 be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EMD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHO USE ONLY <br /> EHD 48.06 <br /> 8127108 <br /> TB/Ta 3Sdd LBZ l7HniN3A XIZi_LN3 LZb0859508 ZZ:00 EBBZ/b0/90 <br />