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Jug 19. 2006 10:46AM Advanced GeoEnvironmegtal No. 5211 2 <br /> DATE kt:;tlVtU c1iQ kw iJUMBER <br /> ,�,, SAN JOAQUIN COUNT'S' <br /> ENVIRONME'N'TAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, P Floot, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:Urww_sigov.orgkhd '- <br /> I, <br /> PUBLIC RECORDS RELEASE APPLICATION ;_�" <br /> APPLICANT:—1 U h din BUSINS=SSIIAGENCY: 1� v�cst� l^40. <br /> ADDRESS: J Oct <br /> PHONE(1y:_.07�9- y�v'7-/fyt�� _PHONE(2):.� - I — . '"1 FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE_ Time; <br /> {Arse allow 10 businvA days from date of application submittal-'Yentsvve.only-must be confirmed) <br /> CHECK BOX To EXPEDITER T.$83.00 FEE( SH OR ECK ONLY)-REQUEST PROCESSED IN 3 BUSINE$S GaY <br /> SIGNATURE OF APPLICANT '( DATE 44-A61�7 <br /> UNIT aISTRISUTrON ❑ Unit t a Unit 2 M Unit 3 ❑ Unit 4 ❑ Unit 5 ❑ Unit 8 Q Other(eIactronitilllstsiM*PS) k <br /> FILE ADDRESS EHD USE ONLY <br /> street t+ Street Name city '( <br /> i <br /> 4. <br /> 490 Ek r t — <br /> �, <br /> 6. Lt'IaS ►� l <br /> Ar AV R <br /> - i <br /> Specific Date Rango of Infonnation Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TI NK(UST)CLEANUP SITM(LOP) ❑ HOUSINd AeATEmENT 0 SQLKI WASTE FACILITY <br /> OTHER CLEAr4UP uITE(NoN-1A11) C1 FooD FACILITY Q WASTE TiRF <br /> UNDERGROUNEj TANK(M0NIT0FiiNGIR1<MOvAL) In Doa KENNEL ❑ DAI;ky <br /> HA ARDOUS WASYsGPNEw TOR ❑CHICKEN RANCH Q WA;TZ ATERTREATtf.ENT PLAN, <br /> TIERED PERIWITMD FACILITY ❑MOTELIHOTEL E7 PURIPER TKVCKIYARIaIC-.EM TO1C_ET3 <br /> ❑TAT7001BOaY PIER(--NC ❑ POOLMPA KD USE APPLICATION SITES <br /> A MEClCALWA5"E FACILITY ❑OTHER(PLEASESPECtrn <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOA REv1Ew - MONDAY-FRIDAY 8:00 Am-5:00pm • EYCLUDwO HOUUA%�. YY <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> a pproprtate box(es). At least one Elle type MUST be-selected, Fay to f209)464-4138 or mail to the address <br /> Indleated above. Address ranges will not be accepted—for additional assistance with file addresses, contact <br /> the EHD.Applications received after 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 bo confirmed <br /> approximately ten(10)days after receipt of application, The files will be held for a maximum of fiv(� businges <br /> dales for rlaview. Appointments 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 neve <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by END staff at the expena,e;of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit}prior to review. <br /> r. <br /> t• 1: <br /> .i, �J <br /> tea,l,yi' y L <br /> EHD 48.4E-4D6 <br /> It14MA <br />