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09/25/2007 08-'.51 FAX 5307585U2,�,, PEDEX KINKO'S DAUIS 1�002/003 _ ) . DATE RECEIVED EHD LOG NUMBER SAN JOAQUIN COUNTY 7 ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209)468-3420 Fax. (209)464-0138 Web: www.sjgov.o (hd (113 PUBLIC RECORDS RELEASE APPLICATION APPLICANT:— � rti►S wF�S I Gh a BUSINESSIAGENCY: oon 3w� �ti� S g�' (C ADDRESS: LL '(1- �,u s De u i C 9 S6(6--e a,3 PHONEC530} 'J58_951.3 —PHONE(2): l-ACSIMILE: TENTATIVE"APPOINTMENT DATE: Time: (Please allow 10 business days from date of application submittal-*Tentative only-must be conft 7 CHECK BOX TO EXPEDITER QUEST•Ses.OQ FEE(CAS HECK ONLY)-REQUEST PROCESSED IN 3 A NATURE OF APPLICANT _ DATE 9 Z 1 .. Electronic Information: ❑List❑Map—Description: FILE ADDRESS EHD USE ONLY Streot N Street Name City ❑ Unit 1 w, 1708 E Af fro Rd 2. d ' De-Vri eso Rqia 1 0/ay L-ed r' AlO 2 $ 3. Z A- cnf'an ❑[]` _.. _--— -- � untt3 4., _qj I j - , ____ ___ ❑ Unit4 T. r i R,c 6d 1--0ai vo ITO ❑ Units a 51 �' i C _G UP 9g-a4 98 apt 92�2,2�9t ID, } - - - al - 9• 2. 1 0 I t4'c ' YLima +�v� / U� ! /YJ�j^V 9� '��' ❑ U nit 6 iolq 1,odr X95 I 91-0 Specific Date Range of Information Requested.From to ENVIRONMENTAL HEALTH DEPARTMENT FILES UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT ❑SOLID WASTE FAG + OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY M WASTE TIRE D UNDERGROUND TANK(MONITORING/REMOVAL) 1113 11 DAIRY - 173 HAZAROOUs WASTE GENERATOR CH 6 WASTEWATER TREA ENT LANT ❑TIERED PERMn7E0 FAciu ry L ❑PVMPER TRucK1YARDICHEM TOILETS 17 TATTOWBODY PIERCING )C AND USE APPLICATION SITES ❑MEDICAL WASTE FACILITY SPECIFY) WELL AND SEPTIC PERMIT O %AVAILABLE FOR REVIEW -MONDAY-FRIDAY 8:D0 AM-5:DoPM -EXCLUDING HOLIDAYS. 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the address indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact the EHD.Applications received after I 3:40 pm will be processed the next business day. r 2. The EHD will nota the applicant if an EHD files exist. An approximately ( ) notify pp y appointment for review will be confirmed a roxlmatel ten 7Q I --""- - -- day aTterreceipt app EiaTioad=-T fie!s wtli e�teldio�a imuril isf ave rusiness days#ar-teview.�4ppointments--- _.. .._.-___.. �.GhEdllldrf'a�i:n�r _riinn 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new applIcation may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant s Future file reviews by the same applicant may require a$98.00 deposit prior to review- EHD USE ONLY EHD4a-0eWFB er0=7 e