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To:San Joaquin County EHD Page 2 of 2 2010-01-26 17.19:20(GMT) .DEM 4157072038 From:Ed MacDaniel <br /> DATE RECEIVED SAN COUNTY EHD LOG NUMUEF <br /> CRREIV D ENVIRONMENTAL HEALTH DPARTm. <br /> 600 E. Main Street,Stockton,CA 95202-3029 <br /> SAN 2 g Zp�p Telephone:(209)468-3420 Fax:(209)464-0138 Web:wwwsjgov.org <br /> ENV IVT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> rLL1MTAAWGROUPi--W7GRS <br /> BUSINESSIAGENCY: <br /> ADDRESS: 3210 GOUGH STREET #105, SAN FRANCISCO, CA 94123 <br /> 415-240-3205 415-707-2038 <br /> PHONE(1): PHONE(2): FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: 2/8/2010 Time. <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must he confimle l) <br /> 13 CHECK BOX TO EXPEDITE REQUEST 9 I EE(CASH OR CHECK)dNL; )•REQUEST PROCESSED IN eUSIN 95 DAYS <br /> SIGNATURE OF APPLICANT 4 DATE <br /> Electronic Information: ❑ListEj Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> — -- -- — <br /> Street l!_ Sheet Name City El Unit 1 <br /> 1 1875 — N. MACARTEUR DRIVE TRACY <br /> 2, 502 E. GRANT LINE RD TRACY Un1t2 <br /> 4" Unit 3 J <br /> 5. <br /> — — Unit <br /> 8. <br /> 7. <br /> 8. <br /> Unit 6 <br /> 10. <br /> ALL <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> CS UNDERGROUND TANK(USTI CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SouoWASTe FAcH."fVEHICLE <br /> IN OTHER CLEANUPSRE(NON4.OP) ❑FOOD FACILITY 8 WASTE TIRE <br /> 0 UNDERGROUND TANK(MONnopiNGIREMOVAL) ODOG KENNEL ❑DAIRY <br /> M HAZARDOUS WASTE GENERATOR C3 CHICKEN RANCH 15 WASTEWATER TREATMENT PLANT <br /> 19TIEREOPERMITTED FACIUTY MMOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMTOILETS <br /> •TATTOOIBODY PIERCING ❑POOLJSPA 17 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) SEPTIC, WELLS <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY S:DO AM-6:00PM - EXCLUDING HOLIDAYS. <br /> -.st uD to ten addresses in the space above. Select the types)of flies from the list above by checking the appropriate <br /> ooxtes). 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(tbr <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointmenfn <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 now application may be <br /> submithed 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$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHoae-aeIs Xo .b .'--' <br />