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5- 9-05; iO:27AM; ;2099836960 # 2,' - <br /> �L <br /> 05,'09r 2NN5 11:45 4540138^�" ENVIRONMENTAL_ HL7 TH Pi�GE N1 <br /> SAN -JOAQUIN COUNTY � vnnt <br /> ENVIRONMENTAAL HEALTH DEPARTMENT <br /> MAY 0 J ?on5 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> ENtMONMENJ HEAj <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.,,, � <br /> PERM1T/SENv � � P <br /> PUBLIC RECORDS RELEASE A,PPL.ICATI =-` <br /> APPLICANT: 'e;Ci4 _ <br /> BUSINESS/AGENCY: 4,.,C. <br /> ADDRESS: v.2 -12 <br /> PHONE(2)/ d9 '5;�D9-ant Q/ _FACSIMILE: 3'— <br /> TENTATIVE"APPOINTMENT DATE; Time:$L D$ /D <br /> U D <br /> _ <br /> � (Please allow 10 business days from date of ap Ilcation submittal."Tentative only-must be confirmed) <br /> � CHECK I3OX TO EXPEDITE REQUEST-$93.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> ' cJ1 <br /> UNIT O Unit 1 Cl unit 2 Unit 3 ntt 4 ❑ Unit 5 ❑ Unit 6 ❑ Other(eiectronic/lists/mapc) <br /> ` FILE ADDRESS <br /> Street# Street Fa—me City EHD USE ONLY �� S <br /> 4W GrJ. Q E t/ c c c �3 c c .2•Rc -- <br /> 2. <br /> 3. <br /> 4. — <br /> 5. _ — <br /> 6. <br /> i 78. <br /> -- - <br /> 9. � <br /> i 10. - —— <br /> tf Specific Date Range of Information Requested: From��4- to L <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> M UNDERGROUND TANK(UST)CLEANUP SITE(LOP) (D HOUSING ABATEMENT ❑SOLID WASTE FACILRYNERMLE <br /> FER CLEANUP SITE(NoN-LOP) D FOOD FACILITY ❑WASTE TIRE <br /> DERGROUND TANK(MONITORINO/REMOVAL) C] DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR M CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> O TI=RED PERMITTED FACILITY U MOTEL/HOTEL O PUMPER TRUCK/YARD/CHEM TOaPTS <br /> d TATTOO/BODY PIERCING d POOUSPA O LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RLCORDS ARE AVAILABLE_FOR REVIEW - MONDAY-FRIDAY 8:00 AM-6:00PM - EXCLUDING HOLIDAYS. <br /> 1, List up to ten addresses in the space above. Select the type(s) 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 mail to the address <br /> indicated above. Address ranges will not be accepted—for additional 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 submitte&When the file is available. <br /> 4. Any file not returned in the same conditlon as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a $93,00 deposit prior to review. <br /> END�H•02-008 <br /> 1114105 <br />