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,0 it • • <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAR 2 t3 2007 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONIVIMT HEALI H 304 Fast Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> PERMIT/SERVICES Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/chd <br /> PUBLIC RECORDS RELEASE APPLICATION ///vvv��' <br /> APPLICANT: 505 P( BUStNE55lAGENCY:_/Y/LLA1/31W�ljt/(///ZOI�III[J�l.ff7Af <br /> ADDRESS: y5/l1 5�15TI�lCIG . !lJdS;N�QSNW�kY,�,Sf/_ 1Tf.' llc.0 LDAIcS S.EAC'�I,[�_ L/ <br /> PHONE(1):1(-&)7 9E�n s�� PHONE(2): .Sf:Q $. -/.O/,S FACSIMILE: (S�T2 Qn 7i <br /> J <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of appilcation Submittal-`Tantafive only-must be confirmed) <br /> I� CHECK BOX TO EXPEDITE REQUEST--$9/5^000 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED 1N 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE _31 <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street tf Street Name <br /> City _ <br /> t SUl Dr A2 FAllZ W Ll4'TjARo units <br /> 2. Unit 2 <br /> 3. <br /> 4, Unita <br /> 5. <br /> 6. UnItii' <br /> 1 l <br /> 7. <br /> 1 <br /> �g. Unit 5 <br /> 9. <br /> TD "_ Unit 8 <br /> Specific Date Range of Information Requested:From 1900 to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES - 7 <br /> - �' NOEROROUND TANK(USTI CLEANUP SITE(LOP) � OI151NG ADATEMENT SOLID WASTE FACILITYNEHICLE <br /> THER CLEANUP SITE(NON.L,OP) 4Rrf0pD FACILITY -/o"�^/i ASTETIRE <br /> NDERGROOND TANK(MONITORINGIREMOYAL) J/r`0'/'pDo KENNEL �f DAIRY <br /> ASARDW9 WASTE GENERATOR HICKEN RANCH �S'YASTEWATER TREATMENT PLANT <br /> �IERID PERMITTED FACILITY 0tEL/HoTEL � UMPER TRUCKIYARDICHEM Tolima <br /> VTT00/BODY PIERCING �OOLISPA AND USE APPUCAT*N STEs <br /> MEDICAL WASTE FACILITY X OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AvAR-AaLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM.5:O0PM - 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(2o9)464-0138 or the <br /> 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 END will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recelpt 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 ba reorganized by EHO Staff at tho expense of the applicant. <br /> Future file reviews by the same applicant may require a$95.00 deposit prior t0 review. <br /> EHD USE ONLY <br /> EMD 4800 e11MOM <br />