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02/03/2011 14:26 925746 AEI CONSULTANTS PAGE 01/01 <br /> RECEIVED <br /> DATE RECEIVED EHD LOG NUMBER <br /> FEB 0 3 2011 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT IVB <br /> ENVIRONMENTAL CrH�A).Tf 600 East Main St. Stockton, CA 95202-3029 <br /> PERMIT/SERVIC�$fep one: (209)468-3420 Fax: (209)464-0138 Web: WWW.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_i (wW� BUSINESSIAGENCY: An coRktwC <br /> ADDRESS: L500 rkUlflb 'D(*13j.0 CITYISTATEIZIP: WMi}tkY C C�1 I <br /> PHONE(1): PHONE(2); 46fOI FACSIMILE; Lj_W)j4:: Q2!j <br /> TENTATIVE"APPOINTMENT DATE; I Time: <br /> (Please allow 10 business days from data of application submittal.*Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST.$115 FE (CAH HECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ZL31�,dU <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Name - City �.._ — unit <br /> 4. unit 3_ <br /> r''.... .,. ..._...._. ?�. C :L1tiflll,C�.T 1� <br /> 6. �•Bauta'rKf.!"� _ — - Unit4 <br /> 7. <br /> 8. ❑Unit 6 <br /> 9, <br /> 10. Units <br /> Specific Date Range of Informatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 11Y_'NDERGROUND TANK(U$T)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT LID WASTE FACp."NEHICLE <br /> OTHER CLEANUP SITE(NDN-LOP) ❑FOOD FACILITY WASTE TIRE <br /> UNADERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ASTEWATER TREATMENT PLANT <br /> MERED PERMITTED FACILITY ❑MOTEUHOTEL PUMPER TRUCKNARDICHEMICAL TOILETS <br /> u TATT00180DY PIERCING ❑PODUSPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:O0PM 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(2091464.0138 or mail to the address Indicated above, Addrass <br /> ranges will not be accepted-for additional asslstan ca 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$116 deposit prior to review. <br /> 6. If you need further assistance,please contact Diane Martinez,at(2091468-3426. <br /> END USE ONLY <br /> IND 49-09 BRIM <br />