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Oct 03 05 11:26a Drew Van Allen 209 F67-9668 p.1 <br /> DATE RECEIVED EHD LOG NUMBER <br /> r , SAN JOAQUIN COUNTY <br /> J ENNrIRONN ENTAL HEALTH DEPARTMENT <br /> 3 ' ��� 304 East Weber Avenue,3`d Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> K. PUBLIC RECORDS RELEASE APPLICATIONA <br /> APPLICANT: Df'{a'� O Alm(/` BUSINESSIAGENCY:_ <br /> ADDRESS: Z� �w -L �rL Til OQK , 'A � <br /> PHONE(1): 7-N:4"( �,y V -y��� PHONE(2): ZoF '6 �O FACSIMILE: Zk':"� <br /> TENTATIVE"APPOINTMENT DATE: L-n (V1 Ov Time: 01 -3c) <br /> (Please allow 10 business days from date of appllcation submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-; 3.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU INESS DAYS <br /> SIGNATURE OF APPLICANT �'�`--��- DATE I� zlo}� <br /> UNITDISTRIBUTION ❑ Unit1 ❑Onit2 ❑Un Unit4 UnItS 0 Unit6 ❑ Other(electronlrAlsWmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street of Street Name city <br /> 2. szw <br /> t4�1 -1 d4Ja� S+r- - y�•atl'{�y "`-W.. <br /> 3. Z IZ61 l Il Qro*b n <br /> 4. �l <br /> 5. 14-t- b:=,~, Cl s4-. I-A L. 2 1 0 V PA 3 154 t,. <br /> 6. -Z�(dZ a t t tdl•.t S4,nix4c4,% <br /> i. X33 . S.�Ckilt <br /> $• 3Zz� N ted- Lam C <br /> 9. 1 Zeas N av Or lv-,` Sc.ic <br /> t—Ic <br /> Specific Date Range of Information Requested:From to (-y .rpg-VA' <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> )%rUNOERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) 13 FOOD FAc;u Y ❑WASTE TRE <br /> ❑UNDERGROUND TANK(MONITDRINGIRvoovAL) ❑ DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERLIITTED FACILITY ❑ MOTELIHOTEL ❑PuIPER TRUCKIYARDICHEM TOILETS <br /> Q TATTOO/BODY PIERCING ❑POOUSPA M LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACIL rry ❑OTHER(PLEASE SPECIFY} <br /> WELL AND SEPTI PERMIT RECORDS ARE AVAILABLE FOR REviEw- MONDAY-FIUDAY 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 submitted when the rile is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by END 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 /> EHD"-02-005 <br /> anmos <br />