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OG/03/2005 10:00 916-37� 809 RANEY GEOTECHN% PAGE 02/0' <br /> IJ li FMf� 11 E D <br /> EHD LOG NVM®ER <br /> ll VV L��� SAN JOAQUIN COUNTY I <br /> ENVIRONMENTAL HEALTH DEPARTMENT I <br /> JUN 0 3 7005 304 East Weber Avenue,Yd Floor,Stockton,CA 95202-2708 /M <br /> ENMRONMENT HEALTH Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd tales <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION 1®) <br /> APPLICANT: DrY'ily A��'I-eew '' rr HUSINESSIAGENCY:TjA C .i <br /> ADDRESS: 4'O GaGeV„� W e Sj,,�, vtiP.,ti .c� S <br /> PHONE(1): 6I'; PHONE/(z) FACSIMILE; Q 16 3--T(" Q <br /> TENTATIVE"APPOINTMENT DATE:_ bh/was rima: 0`) 00 <br /> (Plena allow 10 business days from ate appllceaen submittal-`TwWrve only-must be mnflrmed) <br /> CHECK BOX TO EXPEOITEREq ST 593.00 FEE ASH OR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS PAYS �I y <br /> SIGNATUREOFAPPLICANT DATE <br /> UNrr DISTRIbU710N ❑ Unfit O UnR2 nh3 Ito nR5 UnItO O Othar(electronlcMstslmaps) <br /> FILE ADDRESS,. EHD USE ONLY <br /> stmt* Street Name .. J .-- City <br /> .. 3..�a- <br /> z. 24�{.. ►�• Way S aC�{ow .... N, _. <br /> 3 1528 E� e �. 1`- <br /> 4. 1_32,$ W:� tag <br /> �- <br /> 7• <br /> 9. <br /> ....... <br /> ..- <br /> 10. <br /> Specific Data Range of Information Raquestad:From 1 C15 to <br /> 1 <br /> J/ ENVIRONMENTAL HEALTH DEPARTMENT�FILES <br /> NPEROROUNP TANN(US'f)CLEANUP 9RE(LOPI HOUBINO ABATEMENT �1SO4n WASTR FAGRlry)YGNN:La <br /> EN CLEANVP SDE(NONd.OP) FaaD FACa.1IT WA9TE TateOEROROUNO TANK(MONRORINCJREMOVAL)' G DOO KENNEL 0 Dm" <br /> ROONE WASTE GENERATOR l O CHICKEN RANCH D WARTEwATER TREAwc%rr PLANT <br /> TIEREO PCOMMM FACIUTT O MOTEIIHOTEL O PUMPER TRUCIOYAROICHEM TOILETS <br /> O TATTOOIRODY PIERCING 0 POOUSPA 13 LAND USE APPLICATION SITS <br /> 0 MEDICAL WASTE FACILrn, E3 OmER(PLEASE sPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAKAeLE FOR REVNW• MONCAY41RmAy 8:90 AMAIAGPM - ERCLUDMO 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 addrass <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 EMD files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after lreceipt of application. The files will be hold 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. <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 /> LHP4M2406 <br /> tn�bs <br /> fi <br />