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DATE RECEIVED FE`:D LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/e d 3 El <br /> PUBLIC RECORDS RELEASE APPLICATION �O <br /> APPLICANT: ,5 V)(0/I ( 5(.077• v4 BUSINESSlAGENCY. <br /> ADDRESS: 3 ( p I r (�•CJ2C�/87/ <br /> PHONE(1): ✓.7L/'tp� dVGZ PHONE 1121: 1��_ &N - 7,560 FACSIMILE: SJCJ�GC7-lD-' S <br /> TENTATIVE*APPOINTMENT DATE:L)U RQ R 7A0$ Time: S.OD <br /> (Please allow tan business day f m date Pf application s mittai-•Ten tive Dnl must co Irmed) <br /> Lg11 �e (Atfl mLortte � �+e 1,7 pDsfi re d kMP <br /> ❑ CHECK 60X TO]EXPEDITE REQUEST,-$98. 0 F E(CASH OR CHECK ONLY)-REQUEST PROC SSED IN T EE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Sf-gty',I} DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street It Street Name City <br /> M Unit 1 <br /> Lt 14 <br /> 2. �✓b$ t(lC W S Jci). '" t unit <br /> 4. I <br /> nit 3 vI- <br /> 5. f\ <br /> 6. Ito > <br /> 7. <br /> B. <br /> ©Unit <br /> Ell E _ <br /> 9, <br /> 1 D. ❑units <br /> Specific Date Range of Information Requested:From j4" 2(x1'1 - to goon <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> *UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Cl HOUSINGAeATEMENT ❑SOLID WASTE FAOILITYIYEHIOLE <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑FOOD PACILRY ❑WASTE TIRE <br /> q�UNDERGRDUNO TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED PACILnY ❑MOTEL7HOTELCI O PUMPER TRUGKIYARO/CHEM TOILETS <br /> TATT00180DV PIERCING ❑POOL/SPA ❑ LAND USE APPLICATION SITES <br /> ❑MENCAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERlAIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-S:OOPM - EXCLUDING HOLIDAY, <br /> 1. List up to ten addresses 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 typo MUST be selected. Fax to(2091464-0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> 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 approximately ten <br /> days after receiptof 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 the EHD staff may not be Immediately avallable for review. A new application <br /> may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHb staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 48-08 1012910] <br /> PUBLIC RECORDS RELEASE APP FDR: <br /> d0/L9 39gd 2I7VO ON Snivais 90099L99E5 9d :69 899Z/9T/99 <br />