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r EHD LOG NUMBER <br /> DATE-RF E <br /> , SAN JOAQUIN COUNTY°�I � � . / _"L <br /> EA NV'IRONIVIEMAL HEALTH DEPARTMENT <br /> ;UN 0 1 2007 600 E. Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (2.09) 464-0138 Web: www.sjgoy-org/c <br /> HEALTH <br /> 9 4150" <br /> EERM1T/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Tammy Woods EUSINESSIAGENCY. Neil O.Anderson &Associates <br /> ADDRESS: 902 Industrial Way, Lodi, CA 95240 <br /> PHONE(1): (209)367-3701 PHONE(2): FACSIMILE: (209)369-4228 <br /> TENTATIVE*APPOINTMENT DATE: June 7, 2007 Time: 0:00 AM <br /> (Please allow 10 business days from date of application Submittal-*rsntative only-must bo confi <br /> D CHECK BOX TO EXPEDITE REQUEST-$95.00 PEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN Afv <br /> A <br /> SIGNATURE OF APPLICANT DATF JUrle ' <br /> Electronic Information: M List U Map—Description: <br /> _ FILE ADDRESS EHD.USE ONLY _ <br /> _ 8trect a — _ Street Name City Unit 1 <br /> 1. 1141 _ S. Anteros Avenue Stockton A) <br /> 2• 1011 Broadway Stockton �Z 3a a a ❑ Unit 2 <br /> 3. 4010 E. Main Street Stockton -unit 3 <br /> 4. 4075 S. Main Street Stock 2n�5 <br /> 6. 412.5 E. Main Street Stockton <br /> — Unit 46. <br /> 7• _ _.. ❑ Unit 5 <br /> Unit s <br /> 1 D. --- <br /> Specific Date Range of Information Requested:From _ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> fs1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) &HOUSING AHATFMENT U SOLID WASTE FACIUTYNEHICLE <br /> I OTHER CLEANUP SITe(NON-LOP) FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 Dqp KENNEL CI DAIRY <br /> HAZARDOUS WASTE GENERATOR - 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ©TIERED PERMITTED FACILITY 13 MOTELIHOTEL LI PUMPER TRUCKIYARoICHEM TOILETS <br /> LI TATTOOI6ODY PIERCING 13 POOLISPA E3 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS, <br /> 1. List up to ten addresses In the space above. Select the type(%)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail 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 FHD 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 be held 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 EHD staff at the expense of the applicant. <br /> Future rile reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> EH048.06 0/1312005 wn13 <br />