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EHL)LOU NUMtStK <br /> TE RECEIVED <br /> SAN JOAQUIN COUNTYAr <br /> ENV R'ONMENTAL HEALTH DEPARTIT <br /> -_ -- <br /> F <br /> 600 East Main St. Stockton, CA 95202-30 b <br /> Telephone: 209 468-3420 Fax: (209) 464-0138 We rg/eh <br /> -J i o <br /> .:;?, {,I PUBLIC RECORDS RELEASE APPLICATION <br /> A �o L BUSINESS/AGENCY: <br /> APPLICANT: t <br /> ADDRESS: © CITYISTATE2lP: <br /> PHONE(1): 3 PHONE(2): �5( �-Co�'S' 2�o FACSIMILE:5l 0-295 - .2 6 S(v <br /> TENTATIVE*APPOINTMENT DATE: (= , 2 . Zo 1 o Time: $Avv--, <br /> (Please allow 10 business days from date of applicatl submi *Te t0ve only-must be confirmed) <br /> CHECK BOX TO EXPEDIT QUE $115 F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUS(NESS AY <br /> SIG TURE OF APPLICA DATE Ag ZSR _ <br /> Electronic Information: List 62P- cript n: +Torn me �J vn <br /> FILE ADDRESS o Q, EHD USE O Y <br /> Street# Street Name City Unit 1 <br /> 1. Z 3 0 1 � c�s+h'i� LJe ;�O <br /> 2. 21 g i O n 2.d ' <br /> da/unit 2 <br /> t <br /> 4. o Cl. �ej k Unit3 <br /> 5. 3 f1, s^�A-nc� -o ��e <br /> 6. Unit4 <br /> 7. iii �Q s : <br /> 8. 2-2-70 i-w- 9 . F� ❑Units <br /> 9. �� <br /> 10. 'r unit s <br /> Specific Date Range of Information Requested: From 3 7717 to Dr-42-se n k <br /> ENVIRONMENTAL REALTH DEPARTMENT FILES — I <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> OTHERCLEANUP SITE(NON-LOP) [I Fool)FACILITY E]WASTE TIRE <br /> NDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEUHOTEL MPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑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-5:00PM(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$115 deposit prior to review. <br /> S. If you need further assistance, please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> EHD 48-68 8127109 <br />