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Oct 03 05 11 :26a Drew Van Allen 209 667-9668 P. 1 <br /> DATE RECEIVED )I EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3 `d Floor, Stockton, CA 95202-2708 <br /> Telephone. (209) 468-3420 Fax: 209 464-0138 Web: 1Arww.sj9ov.org/ehd <br /> ) sjgay.org/ehd <br /> I�11;{�tl <br /> . KI i - PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Dry a .n At4� <br /> BUSINESSlAGENCY: <br /> ADDRESS: <br /> PHONE (1): Z% '( C416 - t3k�y ?- PHONE (2)' Z""� f � �� ' (O 73 �y FACSIMILE: <br /> TENTATIVE" APPOINTMENT DATE: r;� li- � O�' OQ30 <br /> Time: <br /> (Please allow 10 business days from date of appllcation submittal - 'Tentative only - must be confirmed) <br /> Q CHECK BOX TO EXPEDITE REQUEST . $ 3.00 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 313U INESS DAYS <br /> SIGNATURE OF APPLICANT � h^- ��-A v� DATE �5� a �� <br /> UNITDISTRIBUT]ON ❑ unit 1 1] Unit2 ❑ Un Unit4Units ❑ Unite ❑ Other (electronicllistslmaps) <br /> OIL <br /> FILE ADDRESS <br /> S <br /> treetstreet Name city EHD USE ONLY <br /> a -cLurvJa n +y- LtL� S c. I MA <br /> 9. 2a�S <br /> AV f]J'IVt_ S4�t, K <br /> 10. Ltl ,1/_ VCA^ tort. <br /> Specific Date Range of Information Requested: From LO 03 to Ly eft-J4' <br /> �.Y� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> VVNDERGROUNo TANK (UST) CLEANUP SITE (LOP) O HOUSING ABATEMENT ❑ SOLID WASTE FACILITYNERICLE <br /> ❑ OTHER CLEANUP SITE (NON4.OP) ❑ FOOD FACILITY ❑ WASTE TIRE <br /> 13 UNDERGROUND TANK (MONITORINGIREMOVAL) Cl Doc KENNEL C3 DAIRY <br /> ❑ HA2ARDOUs WASTE GENERATOR ❑ GlICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL 17 PUMPeR TRUCKIYARDICHEM TOILETS <br /> 111 TATTOO/BODY PIERCING 0 POOLISPA ❑ LAND USE APPLICATION $ITES <br /> ❑ MEDICAL WASTE FACILITY ❑ t7rHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW M0NDAY-FPIOAYS:00AM-S:OOPM - EXCLUDINGHoUDAYS. <br /> 1 . List 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 to (209) 464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted - for additional assistance with file addresses, contact <br /> the EHD. Applications received after 3:DO 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 <br /> approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is activefy 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 of the <br /> applicant Future rile reviews by the same applicant may require a $93.00 deposit prior to review, <br /> ExD osazone <br /> fnaros <br />