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FEB. 8. 2006 9: 16AM CON", <br /> EARTH TECH � N0. 5521 P. 2/2 <br /> �I C�� EHD LOG NUMBER <br /> { <br /> ft7Jl LL�� SAN rO Quint CourtTi <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> FOR — 0 0006 304 East Weber Avenue,34 Moor,Stockton,CA 95202-2708 0 <br /> Telephone;(209)468-3420 Fax:(209)464-0138 Web;www.sjgov.org/ehd /v <br /> ENVIROWOENT HEALTH <br /> PERMIT,'SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> ASA dP/J' BUSINESSIIAGCori <br /> ori l <br /> ADDRESS: IPS Fa44k W, 6Ikfjf-r u:cde. t CA <br /> PHONE(1):,0,09 4U1+_OSIQ . PHONE(7.):209 i3l{K 1901r A _FACSIMILE: 4699—eW -175'36 <br /> TENTATIVE'APPOINTMENT DATE: Time: . <br /> (Please WeW 10 budnasa days fiom of application submktal--TentabW only-must be confirtnCO) <br /> CHECK BOX TO l7(p RE EST-Se0.00F ( HOR CHECK ONLI�-REQUEST PROCESSED IN 3B <br /> SIGNATURE OFAPPLICA T DATE ' <br /> UNIT DISTRIBUTION O Unk1 ❑Unk2 UnkS O Vnm4 MUMS O Unke d Other(elcchnnlNlwts/maps) <br /> FILE ADDRESS EHD USE ONLY <br /> Sheet Sheet mama Clty <br /> 1. „mss_ rYt <br /> a. at W&Lsu4 V&u ) <br /> IMH6. fs <br /> z , ILL ki Hila <br /> 8. <br /> Specific Date Range of Information Requested:From to ' <br /> �� ENVIRONMENTAL HEALTH DEPARTMENT FILES — <br /> MYyNOERGROUno TANK(UST)CLEANUP SME(LOP) Ar <br /> I181NGMATEMENT IB$OUOWASTEFACIUTYNEMCLE <br /> ��{''�iXm CtFnNUP SITE(Nom-LOP) 00 FACIUTY O WA TIRE <br /> UNDERGROUND TANK(MONnORRmIREMOV, 0KENNEL E3 DAIRY <br /> ❑HAZAROom WASTE GENERATOR ICKEN RANCH E3 WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FAaLrrY O7ELIHOTEL rO.�PUM�ER TKOCK/YARDIMHEm Toi <br /> 0 TATipOIBODY PIERCING 0 POOL/SPA M�LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACR27Y O OTHER(PLEASE SPECIFY) <br /> WELL ANO SEPTIC RecORos ARE AMLASLE POR REVIEW'•MONDAY-FRMAY 0:00 AM-6:00m - EXCLUOING HOLIDAYS, <br /> 1. List up to ten addresses in the space above. Select the types)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 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 actively 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. lI <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 the same applicant may require a$93.00 deposit prior to review, <br /> ,6+ n <br /> EHDM42AN <br /> imlN6 - ``II <br /> 1I <br /> !y <br />