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i <br /> � nu •numtsrrc � <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> Y ENVIRONMENTAL HEALTH DEPARTM T <br /> 304 East Weber Avenue,.3rd Floor, Stockton, CA 95202-2708;: <br /> Telepho .{ 9)4,68-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> 2005 APR 26 AM ill, JAI <br /> PUB RECORDS RELEASE APPLICATION <br /> �f APPLICANT: <br /> M BUSINESS/AGENCY: VVVI ONHENTAL <br /> �l ADDRESS: a x <br /> PHONE(1): 7' PHONE(2): Df— 3-z FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time:'.. <br /> (Please allow 10 business days from d to of a lication submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQU T'-i$93.0 F ASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 US ESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> UNIT DISTRIBUTION ❑ Unit 1 ❑ Unit 2 E3Unit 3 E3 it 4 Un ❑ Unit 5 0 Unit 6 ❑ Other(electronidlistsimaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Narrie City <br /> F.2. <br /> 00 9 r4 } 3 <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> F-9-1 <br /> 10, <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> HER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY <br /> PTr0❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL DAIRY <br /> L7 HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTELIHOTEL., 13PUMPER 7RUCK/YARDICHEM TOILETS <br /> ❑TATTOO/BODY PIERCING 1:1POOLISPA 171 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) I' <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REv1Ew = MONDAY-FRIDAY 8:00 AM-5:00PM. - EXCLUDING HOLioAYS. <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 3:00 pm will be processed the next businessi day. <br /> 2. The EMD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten (i 0) 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 actively being worked ,on by EHD staff may not be immediately available for review. Anew , <br /> application may be submitte.'c1`VIkher 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 file reviews by th'e same applicant may require a $93.00 deposit prior to review. <br /> !H ±"2-006 - it <br />