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A I� Dec. 8. 2005 2:28PM f ',anced Geolnvi ronmental <br /> i „ No. 3195 P. 1 <br /> -DAT" VE — �. <br /> -T <br /> I� �J r'' EHO LOG NUMBER <br /> 11 Du SAN JOAQUIN COUNTY <br /> ENVIRONmmNTAL HEALTH DXPA.RTM ENT <br /> D E t, -- G 1005 304 East Weber Avenue, 3"IFloor, Stockton, CA 95202-2708 <br /> TelePboue:(209)468-3420 Fax:(209)464-0138 Web;www.sjgov.oWehd <br /> EWIRThi <br /> P .R0,1 ;a PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT. Suzanne Henderson BUSINESS/AGENCY: AdvaGe n n 1 <br /> ADDRESS: 837 Shaw Road Stockton CA 95215 r�Ced <br /> ns— <br /> PHONE(1): 209-4$7 om PHONE(2):. . Coll;209-792-2278 <br /> FACSIMILE: 2 67-1118 <br /> TENTATIVE"APPOINT 9NT DATE A n P <br /> (PIOW allow 10 6W61nes5 days fGnm date of Tlnt°:— v9( <br /> epplicatian euDrnittal--7ent�onry-must bo confirmed) �.•. <br /> i CHECK BOX TO EXPEDITE R>~ T•895,00 FEE( H OR ECK ONLY)-REQUEST PROCESSED IN 8 B IH DAYS <br /> SIGNATURE OF APPLICANT DATE 9oZ <br /> UNITDiSTR18t1710N ❑Unit 1Unit 2 Unit 4lnit 4 ❑Unit 5 ❑ U,it- <br /> C3 Other(eleotYoeicllistgJm9ps) <br /> FILE ADDRESSStrom 4 <br /> # Street Name city EHD USE ONL <br /> 2. 3 �� <br /> 3. L <br /> 4. C 1--` <br /> 6. i1 U <br /> M a <br /> 7. cfk t-o <br /> 10. <br /> Specific Date Range of Information Requested:From <br /> to <br /> ENvIRONMeNTAL HEALTH DEPARTMENT FILES <br /> N UNOEMROUND TANK(UST)CLEANUP SITE(LOP) d HOUSING ABATEmen ❑SOLID WASTE FACUJTWVFACLE <br /> PQ OTHER CLEANUP SITE(NON-LOP) 0 FOOD FAcruTY ❑WASTE TIRE <br /> IIQ UNDERGROUND TANK(MONrrowNGA;tEMOVAL) ❑Doc KENNEL ❑DAIRY <br /> M HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑wASTEwATER TnEA71aENT PLANT <br /> 17 Y1EREa PERHInTED FACILITY ❑MOTEL(HOTEL I7 PUMPER TRUCKIYARD/CHEm ToiLETs <br /> 17 TATTOOIBODY PIERC3NG- ❑POOLf3PA 10 UW40 USE APPLICATION SuEs <br /> ❑MEDICAL wtL4TE FAdLrTY O OTHER(PLEASE SPECIFY) <br /> 9 <br /> WELL AND$EPTIC"IT RECORDS APA AVAILABLE FOR REview- MONDAY-FRIDAY 5:00 AM-S:OOPM - EXCLMNG}tpLIDAYS. . <br /> 1.!Llst up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> ,?appropriate box(es). At least one file type MUST be selected. Fax 2 464-0138 or mail W the address <br /> i n cated above. Address ranges will not be accepted–for additional assistance with file addresses,contact <br /> 1the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2.;;The END will notify the applicant if any EHD fifes exist. An appointment for review will be confirmed <br /> 'ppproxlmately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> Pays for review. Appointments should be scheduled accordingly. <br /> 3. A Tile that Is actively being worked on by END 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 of the <br /> applkant. Future file reviews by the same applicant may require a$93,00 deposit prior to review. <br /> tnM6 <br /> k <br />