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From:hlarcus H. Bole & Associs 530+633+0119 I 12d'009 16: 12 #140 P.001 <br /> i <br /> I <br /> EHD LOG NUMBER <br /> SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTHI DEPARTMENT <br /> t "-� 0 7 2009 600 East Main Street, Stockton; CA 95202-3029 <br /> T' I <br /> ENVIRONMENT HEALTRelephone: (209)468-3420 Fax: (209)464-i 138 Web: www.sjgov.o <br /> pRMITISERVICES PUBLIC RECORDS RELEASE E APPLICATION <br /> APPLICANT: [ '!fro <br /> v /l]-'_ I BUSiNESSIAGENCY: <br /> ADDRESS: �0 7/ �r c k !�//�'E' City1statelzip lyxe.cL T 1 ian <br /> PHONE(1): , � 6,S3 //-7 ..,,..._ PHONE(2):e�3�—G// halo,7 1 �cl FAC LE ),>'L� 'H 53.'.Oid <br /> TENTATIVE*APPOINTMENT DATE; ur" I Time: <br /> (Please allow 10 business days from dale of application submittal-'Tentative only-must be confirmed) <br /> D CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> /�f�i*�-� DATE - <br /> S}GNATUREOFAPPLICANT �///�4 r?_'5������-`E�P , _ �—, <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> -street# 1 Street Name Cit. © Unit 1 <br /> r��1�17_ �7f o c1 011/t P rl r <br /> �' Unit 2 / <br /> 2. g3 S_ A xam 419nr <br /> 3. 01, <br /> T Anit <br /> 4. <br /> 7. /l _� it 5 <br /> B. <br /> $ <br /> D. l L <br /> Specific Date Range of Information Requested. From ! to <br /> I <br /> ,.,// ENVIRONMENTAL HEAL TI`{DEPARTMENT FILES <br /> 01UUNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT -SOLID WASTE FACILITYIVEHICLE <br /> 9 UTHER CLEANUP SITE:(NON-LOP) 0 FOOL!FACILITY 0 WASTE TIRE <br /> �Q-tT ERGROUND TANK(MOMTORINGIREMOVAL) ©DOG KENNEL 0 DAIRY <br /> AZARDOUS WASTE GENERATOR 13 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> C1 TIERED PERMITTED FACILITY ❑MOTEL.IHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> •TATTOOIBODY PIERCING 17 POOLISPA 0 LAND USE APPLICATION SITES <br /> •MEDICAL WASTE"FACILITY 0 OTHER(PLEASE SPECIE Y) <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(s)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. Applicatlons received after <br /> 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 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 file reviews by the same applicant may require a$105 deposiIt prior to review. <br /> EHD USE ONLYI <br /> I <br /> EHO 48.06 8104/08 1 PUBLIC RECORDS RELEASE APP FORM <br /> i <br />