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Apr. 23. 2007 9:42AM Ad.unced GnEnvironmentaI No. 8342 P. 1 <br /> I? EREJ 1/ 13 <br /> u;I „�”j- ,; 4i•r�i i �i ' SAN JOAQUIN COUNTY Loc�vurwf3rR_ <br /> I <br /> ENMONMENTAL HEALTH DEPARTMENT <br /> A RP 2 IS 2007 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-270 <br /> Telephone: (209)468-3420 Fax: (209)464-01.36 Web: www.sjgov,orgl d <br /> Dr- �,,1; �E=_';'i SLS PUBLIC RECORDS RELEA <br /> SE APPLICATIO <br /> 32 <br />'I <br /> APPLICANT; <br /> �j BUSINESSIAGENCY: .k.hJ g1 C.,A&Ar]IUII'0111MArf tf <br /> ADDRESS: /f A� <br /> PHONE(1): 02 1,0 Q(p PHONE(2)-AQ �•r1. FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE. Time! <br /> (Plaase allow 10 bull.......days from date of applfcati su6mltt i-"Tenta!!ve only.mu$t 17e finned) <br /> CHECK BOX TO EXPEDITE O EST-$85.00 FEE(C H OR C ECK ONLY)-REQUEST PROCES6iED IN 3 8 SINE DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic information: 0 List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> 9treat Street Name <br /> CI <br /> 133 5• n <br /> El <br /> 1337 <br /> [2. Xe2 Fj V-17 <br /> aI e2 9v`"� <br /> (P ( 3S �, ❑ Unit2 <br /> 3. tti ,rte ff 1f <br /> 4' E . Fr <br /> �✓IU Lfnft s <br /> 5. F <br /> M MnA A' <br /> F'+ <br /> 7. <br /> --- ❑ Unit 6V <br /> ... --- ❑ Unit 6 <br /> Lo <br /> Specific Date Range of Information Requested-Fr m <br /> II go to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILE$ <br /> p �A UNDERGROUND TANK(LIST)CLEANUP SITE(IOP) n HOUSING ABATEMENT13 SOU6 WASTE FAGLITYNEFiICLE <br /> X OTHER CLEANVP 51TE(NON-LOP) M F000 FACILITY ©WASTE TIRE <br /> UNDERGROVND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WA 1-1i GENERATOR ❑CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELIHOTEL - 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> TATToo/BoDY PIERCING 13 POOLISPA AND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) W <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR PEMEW- MONDAY-FRIDAY 8:00 AM-6:00PM - EKCLUOING HOLIDAYS. <br /> 1. List up to ton addresses in the space above. Select the type(a)of files from the list above by checking the appropriate <br /> bax(es). At least one fila 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 EHb.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(40) <br /> days after recelpt of application. The fifes will behold 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 fila 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$85.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD"-06 9113QMB <br /> 1 <br />