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11/ZU/20U5 15:28 San Joaquin County –>. 4640138 2 <br /> EHD LOG NUMBER <br /> LO SAN JOAQUIN COUNTY <br /> i+ 0 2009 ENVIRONMENTAL HEALTH DEPARTMENT 400001' <br /> 800 East Main St.Stockton, CA 95202-3029 <br /> EN i1-1 Ns`�H-P-A F7�lephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.orgle <br /> "L ' 'I/USER'v`IJE, PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_jDC_AAi, 12nwfF B SINESSIAGENCY: <br /> ADDRESS: T, . ,r v CITYISTATEIZIP: <br /> PHONE(1): �,2v'f? PHONE(2): FACSIMILE: Ozyi) q44-o57_;5 <br /> TENTATIVE'APPOINTMENT DATE: 1]j�C 4 fir, q Time:_,jo:po <br /> (Please allow 10 business clays from date of application submittal-'Tenfative only-must bo confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115 FEE(CASH OR CHECKONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE IJaV j`�. U. 1 <br /> Electronic Informatfon: ❑Llst❑Map–Descrfptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> street# Street Name A P N city / <br /> — ❑Unit 11. � v <br /> 70r;. Coir,,rR� Czar a <br /> 2• .213A !'D. 173-•Or•o Unit <br /> 3. �4$ e rrC. ;ltiaN 4 pts rib-! Lei r <br /> 4' 1/3975 G. Ft wY jif� - <br /> 6- 3`i !d.CHG._Ok i LN 04 3 1yo-o'; 1_001 <br /> 6V-t�?Ttc_wl4m 0+5 /'_at eV4 <br /> 7. <br /> 8, <br /> 0 Unit 5 <br /> 9. <br /> 10. ❑Unit 6 <br /> Specific Date Range of Information Requested: From J ;rp to __('U>L.P.C,N(- <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILETS - <br /> ®UNDERGROUND TANK(UST!CLEANUP SITE(LOP) ❑HOUSING ABATEMEN r SOLID WASTE FACILITYfVEHICLE <br /> OTHER CLEANUP S€TE(NON•LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ®UNDERGRDUND TANK(MONITORINoIREmovAL) ❑DOG KENNEL ❑DAIRY <br /> ®HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERM iTTEO FACILITY d MOTELIHOTEL ❑PUMPER TRUCKIYAROIC HEM[CAL TOILETS <br /> TATToO]BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPE',IFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE i=Olt REVIEW: MO DAY-FRIDAY 8:00 AM•6.0PM(EXCLUDING HOLIDAYS) <br /> 1. List uo to ten addresses in the space above. Select the types)of I'll as from the list above by checking the appropriate <br /> box(es), At least one file type MUST be selected. Fax to 20 464-0 8 or mail to the address Indicated ab ve Address <br /> ranges will not be accepted-for additional assistance with file add r sses,contact the EHD. Applications 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 appoIntrTiont for review will be confirmed approximately ten(10) <br /> days after receipt of application, The files will be held for a maxImuin 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 lmm diately 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 some applicant may require a$115 deposi 6 prior to review. <br /> 6. if you need further assistance,please contact Diane Martinez,at(20 9)468.3426. <br /> EHD U99 ONLY <br /> EHD 48-09 8f477r}9 <br />