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01/11/200111' 188: 40 92574886 AEI CONSULTANTS PAGE 01/01 <br /> 8 <br /> 1 ►'EGRV`D SANEHD LOG NUMBER <br /> JAN 1 1 2011 ENVIRONMENTTALAL HEALTH COUNTY LTH DEPARtMENT <br /> 600 East Main St. Stockton, CA 95202-3029 59193 <br /> ENVIRONMENTAL HE/L*Phone: (209) 465-3420 Fax: (209)464-0138 Web: vvvvw.sjgoV.Org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:-, tJ tom• ti!!N BUSINESSIAGENCY: <br /> ADDRESS: D (' 11f(JL�(ggLp CITY/STATEIZIP: y AjI,,) ( CA I <br /> PHONE(1); 0 PHONE(2): FACSIMILE! <br /> TENTATIVE*APPOINTMENT DATE l Time: <br /> (Please allow 19 business days from data of application submittal-•TenintAre only•must be confirmed) <br /> ❑ CHECK BOX 70 EXPEDITE REQUEST 4115 FE (CAH HECK ONLY)•REQUEST PROCESSED IN 3 8V$INE5S DAYS <br /> SIGNATURE OF APPLICANT DATE_ 1/1, ZeU <br /> Electronic Infor atlon: ❑List❑Map–Description: <br /> _ FILE ADDRESS EHo USE ONLY <br /> Street# Street Name City QUplt.1_ <br /> 2.3. - _. _.. __ unk2 II21 <br /> 4. <br /> nit3 <br /> 6. <br /> 7. <br /> it 4 <br /> 9. <br /> 10, <br /> Unit e <br /> Specific Dote Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HousING ABATEMENTLID WASTE FACIUTYNEHICLE <br /> tvNDERGROUND <br /> THER CLEANUP SITE(NON-LOP) [I FOOD FACILITY WASTE TIRE <br /> TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> AZAROOUS WASTE GENERATOR F1 CHICKEN RANCH f��y;/��'�ASTEWATER TREATMENT PLANT <br /> Timm PERMITTED FACILITY F1MOTELIHOTEL FPL TRUCKNARDICHEMICAL TOILETS <br /> TATTOOIBODY PIERCING ❑POOLISPA <br /> [71 MEDICAL WASTE FACILITY El LAND USE APPLICATION SITES <br /> ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 9:00 AM-5t00PNf(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 /> b x(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 applicatlun may be <br /> submitted when the file is available. <br /> 4. Any elle 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 /> e. If you need further assistance,please contact Diane Martinez,at(209)468-3425, <br /> sob use omr <br /> cud�a-oe <br /> Nlrla9 <br />