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Feb 06 08 09: 45a Marda Tyree Herbert (925) 947-3738 p. 1 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: '",' w.sjgov.or <br /> PUBLICE <br /> RERELEASE APPLICATION <br /> APPLICANT: Iv I( d t H e-1' _ <br /> BUSINESS/AGENCY: w� <br /> ADDRESS: �J15 VV. Pine 'b�. t Stt? . 5 Lodi LA 61624-D <br /> PHONE(1):(Zo��3�J� - J,O�J K753PHONE(2): ('1 25)Z12, Cj11'1 FACSIMILE: L SDI 1 'J;3 <br /> TENTATIVE*APPOINTMENT DATE:�V�[J . ��b. I Z -2-0 0 ebl Time: 1 3D �rti'L (pr <br /> (Please allow 10 business days from date of application submit al-*Tentative only-must be confirmed) g <br /> ,CHECK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS POs51ble <br /> SIGNATURE OF APPLICANT /l -1 17 11 �D 0 <br /> I ILL <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City i ❑ Unit 1 <br /> u l k 12 ryl i>1 GLlS <br /> S-1 G Port CC Styx Sfio C_I LtCV) <br /> 2. x-14-1 W. VV'Q_;.hin -4C:�)r1 St. C_k#-o /-/r ❑ Unite <br /> 3 5 2b IN_ 1�1Ct511i n i ori S{. S+VTG' bY�- � ✓ <br /> 4 ZZo t YyaShir�Ean Sf. S �j- y�d�ax Unit 3 <br /> 5. 2 r,2I Po+- R o aid S I-r z k lv r� , <br /> 6. <br /> Unit 4 <br /> 7. <br /> 8 ❑ Unit 5 <br /> 9. <br /> Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From ��lJ� ► P S to re.Sen <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITYWASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY M MOTEUHOTEL 0 PUMPER TRUCK/YARDICHEM TOILETS <br /> 0 TATTOOIBODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <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.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 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> **" If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br /> EHD 48.06 9/14/2006 <br />