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Oct 27 05 08: 39a and a <br /> Lush 916 2703 P. 1 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT goa6q? <br /> 304 East Weber Avenue,3rd Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.Sjgov.org/ehd <br /> "2005 OCT 27 AM 9t 27 <br /> l� <br /> PUBLIC RECORDS RELEASE APPLICATION _ r� <br /> APPLICANT: li�t�r Ick C.J LL sti (� BUSINESS/AGENCY: J�• ��� u'�•AL• <br /> ADDRESS: 7L'f.l� W. 4N \� ffb l.T ..` <br /> PHONE(1): (91 0 6)Q I — 16 3 fi'U PHONE(2): �(o � ( FACSIMILE: q(F 24'p <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Pte,ase afiow 10 business days from date of applIcatlon submatal-•TentafNe only-must be confirmed) <br /> 69 CHECK BOX TO EXPEDITE REQUEST- .00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 12 - DATE /(717 poi <br /> UNIT DISTRIBUTION ❑unit 1 ❑unit 2 n Unk 0 Unit b ❑ Unit 6 ❑ Other(electmnlcfastslmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Strad0 Street Name CRY <br /> 4 Cha h <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested:From to P e-rF:vs <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 'rte y <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT O SOLID WASTE FA f NIitr'� <br /> MOTHER CLEANUP SimINON-LOP) 13 FOOD FACILITY O WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGRiEMOVAL) ❑DOG KENNEL ❑DAIRY <br /> UR HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 13 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTOOIBODY PIERCING 13 POOLISPA 13 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - ExcLUDINO 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 <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address <br /> Indicated 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 be confirmed <br /> approximately ten (10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. 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 new <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 EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EHD u 422 <br /> Tnuoa <br />