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\460, EHD LOG NUMBER <br /> DATEREGEIVED <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> 5 2NS Telephone: (209) 468-3420 Fax: (209) 4640138 Web, www.sjgov..org/e r3 Td <br /> - N <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> WATtaj <br /> APPLICANT: AICIL- 519MI V <br /> 6 LL�Vq BUSINESS/AGENCY: 5teggA6�Xft- <br /> ADDRESS: City/State/zip vegslJ L.A. 'V3-110 <br /> PHONE(1); *1-ILISI PHONE(2), FACSIMILE: 6Z5) 7,11 <br /> TENTATIVE*APPOINTMENT DATE: 0d*V Ybbt Time: -`)- I1 F"'VA. <br /> (please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> 13 <br /> CHECK BOX TO EXPEDITECHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 101111-0P,— <br /> [**onic Information. L]List D Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit I <br /> ViOXCA-tno tOtD D :75o c fe 2 Unit 2 <br /> 2. <br /> 3. <br /> Unit 3 <br /> 4. <br /> Unit 4 <br /> 6. <br /> 7. ri unit 5 <br /> 8. <br /> Q unit 6 <br /> 10. <br /> Speciflo Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 1111 UNDFRAROUNDTANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT 0 SOLID WASTE FACIUTYNEMICLE <br /> 19"ER CLEANUP SITE(NoI44-OP) 13 FWD FACILITY 0 WASTE TIRE <br /> Ila UNDERGROUND TANK(MONITORINGIREMOVAL) E3 DOG KENNEL C3 DAIRY <br /> 91 HAZARDOUS WASTE GENERATOR 173 CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 13- MoTEL1HOTEL 13 PumPERTFtUCKIYARDICHEM TOILETS <br /> C3 TArroofflorw PIERCING 13 POOL/SPA 0 LAND USE APPLICATION SITES <br /> E3 MEDICAL WASTE FACILITY In OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC:PERMIT RECORDS ARE AVAILABLE FOR REVIEW -MONDAY-FRIDAY 8:00 AM-6:00PM -Exci-unma HOLIDAYS. <br /> 1. List up to ton addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(20R)464-0138 or mail to the address Indic to above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,Contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> Z. The EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held 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 file not returned its 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> I .d CI-100 u,41aa ejjaiS etrg : ll 80 tT '400 <br />