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FEB. -20' 07(TUE) 18 17 VER°I R INC. TEL °9622678 P. 001 <br /> C E IL LI <br /> PATE1RECEIVED EHD LOG NUMBER <br /> FEB E 2007 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DL,PARTMrNT �] <br /> ENVIRONI-vit_NT HEAL!H 304 Gast Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 L <br /> PERMIT/SERVICES Telephone: (209)468.3420 Faxi (209)464-0138 Web: www.sjgov.org/chd <br /> PUBLIC RECO"S RELEASE APPLICATI <br /> APPLICANT: M%tP�-� 01-WAR�IIIS� v{ BUSINESSIADENCY: erslu�0�G <br /> n . - <br /> ADDRESS: fppqµ>q ll 'StA 11VC..!i r i�'[ 1:; 6 ?sLA S1217 , -I <br /> PHONE(1): 116-143-93321 PHONE(2); 1% 1163-93" FACSIMILE:9l4^96.1^.?6'�A <br /> TENTATIVE`APPOINTMENT DATE! Time: <br /> (Please allow 10 business days from data of application supmatai-'rentable only-must be confirmed) <br /> C1 CHECK BOX TO EXPEDITE K__Q {63.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS GAYS <br /> SIGNATURE:OF APPLICA I DATE 2 <br /> UNIT DISTRIBUTION n 1 Munit 2 ❑Unita PUnft4 r7Una6 IM UnIt6 A Other(electronlcllletalmapo) <br /> FILE ADDRESS EHD USE O LY <br /> street4 street Name C1 <br /> 1, C if&I<C& LNL� a <br /> 7- Z5 " 001 <br /> 1^00 ry <br /> 8, p. O ty\ <br /> B. <br /> 7. <br /> UG <br /> Specific pate Range of Information Requested:From <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,P WNCERGROUND TANK(UST)CLEANUP SITE(LOPI M HOUSING ABATEMENT ❑SCUD WASTE FAQUTYNEHICLE <br /> 0 OTHER CLEANUP SITE(NON•LOP) AFOOD FACILITY GI WARTS TIRE <br /> ;MUNDERGROUNo TANK(MONITORINGIREMOVAL) M POG KENNEL C DAIRY <br /> 11ArARDOUs WASTE GENERATOR M CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> I3 TIeRPA PERMUTED FACILITY ra MOTTSJHOTEL 0 PUMPER TflUCKNAflpICNEM TOILETS <br /> In TATTODIRODY PIERCING Q POGLISPA ❑LAND 119E APPLICATION SITES <br /> G MEDICAL WASTE FACILITY P OTHER(PLEASE SPECIFYI <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVARAPM FOR REVIEW - MONOAY-FRIDAY 6:00 Aa-6loopM - EXCLUDING HOUDAY6, <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 /> approprlate box(es). At least one file type MUST be selected. Fax to 120 1 ASa Oa38 or mall to the 4d rasa <br /> indicated albove. .Address ranges will not be accepted—for addlt1 nal assletance with fila addresses,contact <br /> the EHD,Applications received after 3:00 pm will be processed the next businesa 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 flies will be hold 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 /> b. 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$23.00 deposit prior to review. <br /> EHD 44-01400 <br /> 7Hya4 <br />