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09/25/2007 08:51 FAX 5307585672 FEDEX KINKO'S DAUIS Z002/003 <br /> 5 DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov,o hd (//.3 <br /> PUBLIC RECORDS RELEASE APPLICATION LL .L <br /> APPLICANT: VV —1 _BUSINESSIAGENCY. con SwITz2w p <br /> ADDRESS: . l jfQ xle-1ue__ _ �S, CA 9 1(53 1 <br /> PHONE ��758"By 3 PHONE,(2): .SJO� �0 Z`1 to, Z- FACSIMILE: <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-•Tentadve only-must be confl <br /> CHECK BOX TO EXPEDITER QUEST-$98.00 FEE(CAS HECK ONLY)-REQUEST PROCESSED IN 3 S A <br /> ATURE OF APPLICANT DATE 9' 2 <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 9 Street Name City ❑ Unit I <br /> 1. 1 70a__ Apno+rolrll RCL 0 j i M:5- q 2--1 ":Ar <br /> W. __ __ � � ❑ '�Unit 3 <br /> ---- --- ❑ unit 4 <br /> s ?t�q! �, pf�;r 5' fter.s- 1Z�C �.acC% NO <br /> 7. f5YoQ�},+� 80a� i D ❑ Units <br /> -. .. 8 : 51 o v _ :N_� G-t_�. uP!f-61, 109 04,9.2 -Mz q/-I-05'5A ot-sv. <br /> 9. 112.1 1 n I t ,!Gir.10�Ir 9 �u� ,, ... yri59� �� ❑ Unit 6 <br /> 10. a�}t Ro � fo�9 l�adr' �Y15 9.2-09 G,A 99—SLS— <br /> Specific <br /> SSS— <br /> S ecific Date Range of Information Requested.From to <br /> P 9 9 <br /> f <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT C]SOLID WASTE FACI <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FA ILITY 0 WASTE TIRE <br /> ❑UNDERGROUND TANK(MOWTORINGIREMOVAL) C3Pt.EAIE <br /> L ❑DAIRY - <br /> ❑HAZARoous WASTE GENERATOR NCH r3 WASTEWATER TREA ENT LANT <br /> ❑TIERED PERMITTED FACILITY EL 0 PVMPER TRUCKIYARDICHEM TOILETS <br /> 17 TATTOOIBODY PIERCING .LAND USE A_PPLICAvoN SITES <br /> r3 MEDICAL WA57E FACILITY SPECIFY) <br /> WELL AND SEPTIC PERMIT O VAAVAILAIILE 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 riles exist. An appointment for review will be confirmed approximately ten(10) <br /> - _----- --bays:ifterlrecelpt-ofappTicatioi-The fiFe willfi TldTofaiWaxih'tfirii of-Tive-busines87days-for--review; .ppointmenfs _�::___._.__.._._: <br /> . chn.�lr11,�-SGtledllf�drenrdinn.ty ... _.. <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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 46-06 WEB WW?DD7 <br />