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09/25/2007 08:51 FAX 5307585672 FEDEX KINKO'S DAUIS I�002/003 <br /> 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 <br /> (113 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: . W e-dt BUSINESSIAGENCY: _ con <br /> ADDRESS: 216, W t`'n C I.L. &,1e- --D-,u t,S, C A 9 SsG(4-e 16-3 <br /> PHONE 1�3� ?S PHONE(2): 30 902-0632- FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-•Tentative only-must be confl <br /> CHECK BOX TO EXPEDITER QUEST-$98.00 FEE(CAS ftECK ONLY)-REQUEST PROCESSED IN 3 S A <br /> ATURE OF APPLICANT ^_ DATE 9' Z <br /> I <br /> 5), <br /> Electronic Information: Ll [�Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 4 Street Name City ❑ Unit 1 <br /> ,u fs fYo d <br /> 2. d D� ri '°1 LOJ i �� U° <br /> MORE, r�t , <br /> N, rA Ori oa 946d l a. <br /> _--—L._ _ _ — � ❑4 Ueit 3 <br /> 1 <br /> 4. rj W. <br /> -s4 <br /> ❑ Unit 4 <br /> s— A(f96q11 . <br /> i 2�n 5 f�c'r. - IL6( LvAZ AJO 6 <br /> . i Rom o L.OA!. O <br /> ❑ Unit 5 <br /> 141,- <br /> e 'ems,,.,v PJ- Unit 6 <br /> ��• � �t Rid Ivjy 1�odr �5 9�-a9 �A 97–Sc$" <br /> Specific Date Range of Information Requested.From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> oft <br /> UNDERGROUND TANK(UST)CLEANUP.SITE(LOP) 0 HOUSING ABATEMENT ❑SOLID WASTE FACT <br /> OTHER CLEANUP SrTE(NON-COPi ❑FOOD FA ILITY 0 WASTE TIRE <br /> E3 UNDERGROUND TANK(MONITORINGIREMOVAL) D K EL ❑DAIRY <br /> Q HAZARDOUS WASTE GENERATOR NCH 6 WASTEWATER TREA ENT CANT <br /> Q TIERED PERMITTED FACILITY EL Q PUMPER TRUCKIYARDICHEM TOILETS <br /> 13 TATTOo1BODY PIERCING A LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY THER{PLEA5E SPEc1FY) <br /> WELL AND SEPTIC PERMIT. O 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(2091464-0138 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 /> ------- --__ flays-after-re�ptoiap�tion=�hefileswlll�b�Telii#o�amazifrlT"i"rtl of�iv�buslness�lays=for-7eview.-_Appointments.--_��---�_—__j- <br /> - _ lilliestbedhled._a .- - <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may lie - <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 /> I <br /> I <br /> EHD IE-08 WEB& 2W7 <br />_ 1 <br />