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02/13/2006 16:23 510-43*76 PSI INC . PAGE 01/01 <br /> n 1i D - SAN JOAQUII�T COUNTY EHD LOG NUMBER <br /> L <br /> FEB t, 3 2006 <br /> ENVIRONMENTAL I EALTDDEPARTMENT <br /> 304 Fast Weber Avenue,3d Floor, Stockton,CA 95202-2708 / <br /> ENVIRONMENT HEALTH Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/obd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: M/' SrMKI 5VVm1k-. BUSINESSIAGENCY: Psz�4Ctc- <br /> ADDREss: A& , S,. jz, to �eA gY(ool <br /> PHONE(I): 17 PHONE(2): FACSIMILE:(i r—(C>— /34-7_ G7fz_ <br /> TENTATIVE"APPOINTMENT DATE: L /y�Cl9 Tlme: f17YYl�LdbH. <br /> (Please allow 10 business days from date of a pllcatfon submittal-"Tentaffw only-must be wnfimled) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 jE(C CH CK.ONLY)-REQUEST PROCESSED IN 3 BUS ESI DAYS <br /> SIGNATURE OF APPLICANT // DATE 2 <br /> uNrr DISTRIBUTION ❑Unit 1 oUnit 2 ❑Unit a 13unit4 MUnit S G unite o other(electronicnials(Inaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Nam City <br /> I'�-a3.cC �+' tek.4i <br /> 2. o ,f S 5 57- <br /> 3- 5-D fs.L <br /> 4. <br /> S. <br /> 6. <br /> 7. <br /> 8. <br /> 8. <br /> 10. <br /> Specific Date Range of Information Requested ro a to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUNDTANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT I7 SOLIDWASTE FACILRYA/EIH-rim <br /> 0 OTHER CLEANUP SME(NON-LOP) MFOOD FACILITY 0WASTE TRE <br /> UNDERGROUND TANK(MOKTMWMEMOVAQ 0DOG KENNEL 0DAIRtl <br /> HALARDOUSWASTEGENatATOR ❑CHICKEN RANCH ❑WAVEWATERTReATmENTPLANT <br /> ❑TIERED PERMITTED FACILITY 13 MOTELIHOTEL 0 PUIFERTRUCKMADICHEM TOILETS <br /> ❑TATTOOMODY PIERCINO ❑POOLISPA ❑LAND USE APPLICATION STIES <br /> ❑MEDICAL WASTE FACILnY M OTHER(PLEASE SPECT" <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAYfIEDAYE:OOAmI5:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addressee 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 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EMP d&02-006 <br /> 1(14Ms <br />