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03/16/2007 15:10 FAX U002 <br /> �1 1 EHD LOG NUMBER <br /> Mr-1 JI D SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAR 1 6 2007 304 East Weber Avenue,3rd Floor, Stockton,CA 95202-2708 <br /> ENvtRON(01rENT HEP,L"iH <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> D <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> = e° '� p ^ <br /> APPLICANT: I\l i e- V, V%k-- -5ke,v,' BUSINESS/AGENCY: WnIls-K,6I i /iSS oGia I oS <br /> ADDRESS: 341U it7.R'r'L tet' �.Cw►e +fc-F 56,k6A .cA 15219 <br /> PHONE(1):(2ocj) 7-3 4--m-L PHONE(2): (101) <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> 13 CHECK BOX TO EXPEDITE RE T- 00 F/EE(CAS OR EC ONLY)•REQUEST PROCESSED IN S BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / w DATE -3/116/07 <br /> Electronic Information: ❑List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> wO+CIr 100 Rup E <br /> 2. �a�e-t 'oa ❑ Unit 2 <br /> 3. NN 07 (j0.iW too 94 E <br /> 4. (�n�vi toe Rj Unita <br /> 5. IT55 1V gryadtwa <br /> Unit 4 <br /> 6. 1905 <br /> 7• 4 00 e0 4Drl -56 G14-6 vt ❑ Unit s <br /> 9. <br /> ❑ Unit 6 <br /> ,0. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT C3 SOLID WASTE FAciuTYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAzARDOUs WASTE GENERATOR 17 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> C3 TATTOO/BODY PIERCING O POOLISPA 0 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten 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(209)464-0138 or mail to the address indicated 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 /> 2. 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 files 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 in 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$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 4606 911312006 <br />