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02/03/2011 14:26 9257466 <br /> AEI CONSULTANTS PAGE 01/01 <br /> RECEIVEDEHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> FEB 0 3 2011 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> ENVIRONMENTAL -e None: (209)468-3420 Fax: (209)464-0138 Web: wwW,Sjgov.OTg/ehd <br /> PERMIT/SERVICES' P <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY: fth�SGIU�C — <br /> ADDRESS: �` 1L� 1 LTJ CITYISTATEIZIP: ;Itk� <br /> PHONE(1): j�1�5 3b''tbs;& PHONE(2): --�06l FACSIMILE: -+0fL � <br /> TENTATIVEE'APPOINTMENT DATE - -, 2bU Time: <br /> (Please allow 10 business days from date of application su4mlttal-'Tentative only-must be confirmed) <br /> ©CHECK BOX TO EXPEDITE REQUEST-$115 FE (CA H HECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATEZ�3 U _ <br /> Electronic information: ❑ List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street NameCity d Unit 1 <br /> ......._........... <br /> Unit 2 <br /> 3• -- - <br /> 4 Unit 3 <br /> 5. - --- --- ---- ------ J'� <br /> 6 Q unita <br /> L7. — Unit6 <br /> ,Specific pate Range of Informatlon Requested: From to ^-- <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ElHOU5ING ABATEMENT LID WASTE FACILITYNENICLE <br /> tl(j) <br /> THER CLEANUP SITE(NON-LOP) ©�-ry FOOD FACILITY OWAWTIRE DERGROUNDTANK(MONITORINGIREMOVAL) Q DOG KENNEL [I DAIRY <br /> ZARDOUS WASTE GENERATOR ©CHICKEN RANCH ASTEWATER TREATMENT PLANT <br /> RED PERMITTED FACILITY El MOTEL/HOTEL <br /> PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM«6:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un toten 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 rile type MUST"be selected. Fax to(2091464-0138 or mail to the address indicated a ova 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 foes 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(209)468-3426. <br /> END USE ONLY <br /> 8l2710D <br /> RHD 48.06 <br />