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DATEREcevEo "'^" "I' ' nced GeoEnvironmental <br /> SAN JOAQUIN COUNTy � No. 1664 EHD P:,..2VUMBER <br /> ENVIRONMENTAL:■.n ALTH DEPARTMENT <br /> 304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www 90v,org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: LL <br /> AD <br /> ADDRESS07- <br /> 'S7 BUSINESS/AGENCY: A <br /> / t+/ o p <br /> PHONE(I z S f4 'T I " K To C"E) 95 20- <br /> .PFICNC/» 1h a\ _ Z r <br /> TENTATIVE'APPOINTMENT DATE:cc <br /> Of <br /> tiJA FACSIMIL � 4v"--•�� <br /> 7 //! <br /> (Phase allow 10 bU61nGsa days from date of application submittal-"Tentaflve Doty me must babe- <br /> CHECK SOX TO EXPEDITE REQUEST- <br /> SIGNATURE OF APPLICANT 7 $93.00 FEE(CASH OR CHECK ONL r).REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> UNRDISTRIBUTIONDATE OfL ,/, <br /> ❑ <br /> Unit 1 ❑ Unit 2 Unit 3 ❑unit 4 ❑ Unit5 ❑ <br /> Unita ❑ Other(9lactrOnlUllatslmapa) <br /> Street a FILE ADDRESS <br /> t Y 7 <br /> An. P .street Name city EHD USE ONLY <br /> 2 <br /> 3. <br /> 4, N0 e <br /> 5. <br /> s.7. sE >W 1K& z F, <br /> 8. <br /> 9. <br />— 10, <br /> Specific Date Range Of Information Requested: From <br /> to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> >:�NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT <br /> ❑OTNER CLEANUP SITE(NON-LOP) FOOD E <br /> OP) ❑WAST WASTE FACILITVNEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL ENNL ❑WASTWASTE <br /> TIRO <br /> C3❑HAZARDOUS WASTE GENERATOR ) Cl DOG KENNEL 1:1 D0.1RY <br /> ❑TIERED PERMITTED FACILITY ❑CKICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TATTOO/eODY PIERCING ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> WASTE FACILITY in PI <br /> O OTHER(PLEASE SPECIFY) ❑ LAND USE APPLICATION SITES <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIbAY 0:00 AM-S:GOPM <br /> EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the <br /> appropriate box(es). At least One file type MUST be selected. Fax to(209)464-0138 or mall to the address <br /> Indlcat_ ewe_ Address ranges will not be accepted–for addlbonal assistance with file addresses, contact <br /> the EHD.Applications received after 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 <br /> approximately ten (10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments 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 <br /> application may be submitted when the fiie iz avallabis, <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the <br /> a plicant. Future file revIeI by the same 2pplie2nt may rBgLllr9 a$93.00deposit prior to review. <br /> NO r <br /> 1142 <br /> �I <br /> EKDA641A68 <br /> V1p65 <br />