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AP r. 23. 2007 9:42AM Advanced GeoEnvironmental No. 8342 F. I <br /> ,).ATE-RE�'E�VEQ, <br /> I <br /> ic"Ir-L! 'V -) S <br /> I L-I <br /> AN JOAQUIN COUNTY EHD LOG NUMBER_ <br /> ENVMONMENTAL HEALTH DEPARTMENT <br /> APR .20' US 2007 304 East Weber Avenue, 3'd Floor, Stockton, CA 95202-270 <br /> Telephone-, (209)468-3420 Fax: (209)464-0138 Web: www.sjgov,or d <br /> 0 <br /> E <br /> +.1V1R R 0 <br /> PUBLIC RECORDS RELEASE APPLICATION 32 <br /> 7 <br /> APPLICANT; <br /> V�- PSI) BUSINESSIAGENCY: Wim ne-ea cwjhul��— <br /> ADDRESS: a r t r- <br /> 'y M -jit <br /> PHONE(1); ROL Y/j 9- 11006 PHONE(2)- FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of apPlIcatl I SubmItt I-*Tenfaflve on Time: <br /> 1Y-Must be cdlifirmed) <br /> CHECK BOX TO EXPEDITE 0 EST-$95-00 FEE(C H OR C ECK ONLY)-REQUEST PROCESSED IN 3 E3 <br /> X INE DAYS <br /> SIGNATURE OF APPLICANT DATE 4/ 5U <br /> Electronic Information: D List D Map-Description: <br /> 7I . <br /> -7- FILE ADDRESS <br /> T- <br /> CI EHD USE ONLY# Street Name yF /33 - <br /> unit <br /> I <br /> )A 7 0 Unlt2 <br /> lk <br /> 6o --�Iia& Unit 3 <br /> — <br /> 4. <br /> r) A) <br /> 6. Unit 4 <br /> 7. <br /> 8. Unit 6 <br /> T <br /> Unit 6 <br /> Specific Date Range of Information Requested; From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) n HOUSING ABATEMENT SOCK)WASTE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) M FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) C] DOG KENNEL DAIRY <br /> 17 <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> '�TIERED PERMITTED FACILITY El WASTEWATER <br /> ❑MEDICOBODY PIERCING UMPER TRUCKIYARDICHEm TOILETS <br /> El MEDICAL WASTE FACILITY ❑ <br /> POCIUSPA AND USE APPLICATION SITES <br /> El OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR PEVIEW- MONDAY-FRIDAY 8:00 AM-6:00pm - EXCLUDING HOLIDAYS. <br /> 1. List Up to ton 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 rZI-10.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 ton(10) <br /> days after receipt Of application. The files will be hold 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$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> PHD48-06 9,13fdL09 <br />