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) ^' EHD LOG NUMBER <br /> it l��! I�' ID1 SAN OAQU N COUNTY ..� <br /> �N'V,I1�.ONM[ENTA[, .�AJ.,Tki DE�'i1RTiVZUNT <br /> 0 7 2007 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> EI;vi pr / FRLL,,4168-3420 Fax: (209) 464-0138 Well: www.eo.san joaquin.ca.us/ d <br /> stir>(Ui!T/S�.RV1GES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �eL.G C-0 BUSINESS(AGENCY: o ` + <br /> ADDRESS: 0 2.- fto�'71�g� 4�r� 1 �9� C,4� S <br /> PHONE: :�iRi —3—tD ( -- FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: ___tQ'l.7,1 C)a Time: <br /> (Please allow 10 business days from date of applicatigiiii0b <br /> Vs CHECK BOX TO EXPEDITE REQUEST•$93.00 FEE--REQUEST PROC 9S SS DAYSSV <br /> SIGNATURE OF APPLICANT (DATE <br /> Department use Onfv <br /> .'7 n !�/1 FFIIL�E�AQDRLESS I1 UNIT <br /> 1. street h Q - �+ .1�t}- hV'f_] City <br /> s;+ Unit <br /> 3. StreetElIt�YK '1U Unit 2 �\ <br /> l la Orly` Gt <br /> A. Street C.�J 01Uo-p .FFt-' <br /> 5, Slreel (�J� t v� (/�/�,v1 Gty �.( <br /> 1 - 6 , 1 o Unit 3 <br /> 6. Street °' k 5c 11-'LK Wk� to�1�•-� N, <br /> 7. Street V 1�h.e„ J T '�-City U*dU r _ <br /> Unit 4 <br /> A, Strrcl city <br /> 9. Street Olt ❑ Unit 5 <br /> 10, $Imre Clt <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> la OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) E] DOG KENNEL 0 DAIRY <br /> 19 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 11-9-TIERED PERMITTED FACILITY ❑ MOTEI_MOTEL 0 PUMPER TRUCKfYAROICHEM TOILETS <br /> M TATTOOMODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFIC) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to_(209)46_4-0138 or mail to the <br /> address indicated above. <br /> 2, EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application, The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be 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 <br /> of the applicant. f=uture fife reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 5, *TENTATIVE appointment dates must be confirmed with EHD staff, <br /> 6. Applications received after 3:00 pm will be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED RHONE PAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> END 48-02-009 -- <br /> a�anaoa <br />