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AUQ'Z9 -OT 16 : 48 From-BROWN AND C TPIELL 916 V5 8805 T-869 P . 0NAR F-048 <br /> D�VK E)) ltf u .\ +I Ij1-=� lI� EHD LOG NUMBER <br /> L" <br /> l — — SAN JOAQUIN COUNTY <br /> A ' i 6� 2007 ENVIRONMENTAL HEALTH DEPARTN[ENT <br /> rt, G <br /> 600 East M42 Fax : , Stockton, CA 95202-30 &r / <br /> ' �� <br /> hFi L )epktonr. (209) 468-3420 Fax: (209) 464-0138 Web : wwws)god <br /> pFRF �;TISERTCU, <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY: W N <br /> SS: vCADDREv ' Ua KTC Wf�tVn y <br /> GL� L! <br /> R NVRk CA fffitolo <br /> PHONE (1): G -3 � 51- PHONE (2): \Nf I CO Z.p l — �'ZL tL- FACSIMILE: <br /> TENTATIVE" APPOINTMENT DATE: CSc1G 'T ' Time: Ip • OdaW, <br /> (Please allow 10 business days from date of a licad n submitral - 'Tentative only - must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE R QUEST - $9T00 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF Al 77A DATE <br /> Electronic Information: ❑ List ❑ Map — Description : <br /> FILE ADDRESS EHD USE ONLY _ <br /> Street # Street Name Re I City ❑ unit <br /> 1 • . FLAi son rj"j' _ � .00" 5l bG[G'j'U Q <br /> 2. 10 ( 16 Wr t. 0 5 de2T06KTJtj Unh2 <br /> Rilts <br /> 4. 0 <br /> W ' (/1KAG C1 V� `L f/ Unita <br /> 6. �a Wlo S !/ 3SNp Unita <br /> 7. for <br /> ❑ Units <br /> 9 . � � � W - -eVY �� fJ ❑ Unit6 . _ <br /> t0. <br /> Specific Date Range of Information Requested: From ai 1 to all <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �DNDFRQROUND TANK (UST) CLEANUP SITE (LOP) <br /> ❑ HOUSING ABATEMENT � 30LID WASTE FACILITYfVEHIGLE <br /> $'OTHER CLEANUP SITE (NON-LOP) QFOOD FACILITY ElWASTE TIRE <br /> I21"gNDERGROUNO TANK (MONITORINO/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> j 0-HAZARDOUS WASTE GENERATOR M CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPERTRUCKIYARDICHEM TOILET$ <br /> TATTOOIBODY PIERCING ❑ POOLI ER-LAND Use APPLICATION SITES <br /> 171 MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEw • MONDAY-FRIDAY 8.00 AMS:OOPM - EXCLUDING 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 /> box(es). At least one file type MUST be selected. Fax to 209 464.0138 or mail to the address indicated above- Address <br /> ranges will not be accepted — for additional assistance with file addresses, contact 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 not be immediately available for review. A new application may be <br /> 1 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 /> ono 4e-0e wee 802007 <br /> I <br />