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DATE RECEIVED � �� r/�p y j (� � EHD LOG N+.1�;1B=R <br /> SA I JOAQUIN COUNT. <br /> 'ENVIRONMENTAL HEAL'I'll DEPARTMENT <br /> 600 East Main Sl-rect. Stockton_ CA 95202-3()2(} <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: vvww.sj�.°..f h(1 <br /> PUBLIC <br /> ± RECORDS RELEASEAPPLICATION copir <br /> APPLICANT: 4J;n BUSINEWAGENCY: 13 . <br /> 1!COl.L CE"Tek _Ak W Y S16G 21g; <br /> PHONE(i): w. 1911• 847- V PHONE(2): _._..,_ FACSIMILE: Ci ."rl*(�( <br /> TENTATIVE`APPOINTMENT DATE: Time: ��r�ttAgCr'r� <br /> (Please allow 1D business days from date of application submittal- `Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-E98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �'------ DATE ray <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USEONLY <br /> Street# Street Name City i <br /> Unit i <br /> 1. lot <br /> Sleasan Com. -ra r, <br /> 2, 2$ ZS" r S4. (o., Avf,-) S-lock��. <br /> 3. -f 2 s Z i to rerw% Lb Ave. S4-o,.4w, <br /> unit 3 <br /> Lodi � <br /> 5. Unit4 <br /> �t <br /> 7. <br /> Unit 5 <br /> 9. <br /> __........ Unit ti <br /> 10. <br /> Specific Date Range of Information Requested: From eartiekF Lo lg-lGt <br /> ,/J ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> tjNDERGROUND TANK(UST)CLEANUP SITE(LOP) C7 HOUSING ABATEMENT .R...r��SOILID WASTE FACILITYIVEWCLE <br /> �THER CLEANUP SITE(NON-LOP) 11 FOOD FACILITY © 1(YASTE TIRE <br /> UNDERGROUND TANK(MONITORiNGIREMOVAL) ❑ Doo KENNEL lrK_4AIRY <br /> �AZARDOUS WASTE GENERATOR n CHICKEN RANCH IVASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL GVP MPER TRUCKIYARDICHEM TOILETS <br /> r TATTOOrBODY PIERCING -n- PPOOLISPA ;LAND USE APPLICATION SITE$ <br /> I�"tUIEDICAL WASTE FACILITY B'OTHER(PLEASE SPECIFY) W at jry.(HS T <br /> WELL AND SEPTIC PERMIT RECORDS APE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:00pM - EXCL.unmo 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 /> type MUST be selected. Fax (209)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses, contact.„ <br /> box(es). t east one file r <br /> 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 riot 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 18-H WEB B?'Bf1Ckj'7-. _ -------- . <br />