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06/27/2006 10:58 FAX Q002 DATE RECEIVED EHD L.00NUMBER SAN JOAQUIN COUNTY ENVTRONMENTAL HEALTH DEPARTMENT 304 East Weber Avenue,3rd Floor,Stockton,CA 95202-2708Z , Telephone:(209)468-3420 Fax:(209)464-0138 Web:%,ww.sjgov.org1ehd 3 PTJBLIC RECORDS RELEASE"PLICA'TION APPUCANT: 1 19� ,�. BUSINESSIAC,ENCY: fx" ��-1_Axoe—. ADDRESS: 1291 0 W. 141kW- 5z tj i*y,- � 'e.)ra L&n ki C 4 Q5 I.I PHONE(1): 9!0 2A 4—*;E" PHONE(2): FACSIMILE tt*4N - TENTATIVE*APPOINTMENT DATE: Tiros: (Please allow 10 business days from date of application submittal•IrOUP0C only-must be ConfilnMd) Q CHECK BOX TO EXPEDITER U -$93.00 FE (C R HECK ONLY)•REQUEST PROCESSED IN 3 BUSINE71D DAYS SIGNATURE OF APPLICANT DATE 1 UNITDISTRIBUiION ❑Unit VffU.it`z M Zt3 ❑UnIt4 ❑Unit O Unit 13 Othar(6IoctronicillsftiITlaps) FILE ADDRESS EHD USE ONLY i Street a i- StreW,,Name Gity 4- I b�T. _ JWkAr!~INt aa►_3___ _ st .1Z�A__ 1�t'� . 6. L7. _ t4 Elm a.A3 4 Speck D21,e Range of Information Requested.From t4 _ ENVIRONMENTAL HEALTH DEPARTMENT FILES UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID wAM FACILITYINIEhTCLE OTHER CLEANUP SITE(NON-LOP) ❑I-=FAcausr ❑WAM THE UNDERGROUND TANK(IAONITORINGIFtEMOVAL) Q DOG KENNEL ❑DAIRY HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH ❑WASTRWATER TR.:ATMENT PLANT ❑TIERED PERMITTED FACKM ❑MOTIRMOTEL ❑PuI RTRUcKIYARDICHSM TOILETS ❑TATTOof84oY PISRGING 0 POOLISPA 13 LAND USE APPLICATtON&TEs ❑MEDICAL WASTE FACILITY E3 on1eR(PLEASE SPECIFY) WELL AND SEPTIC PERMR RECORns APE AVAILABLE FOR REVIew- 1IIONDAY•FFjoAY8:00 A":00Pm - ExetuDING HOLIbAYS. I. Inst up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one elle type MUST be selected. Fax to(209)464-(1135 or mail to the address indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant If any EHD files exist. An appointment for review Y411 be confirmed approximately ten(10)days after receipt of application. The files will be held for a maximum of five busivless days for review, Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file Is available. 4. Any file not returned In the sande condition as released will be reorganized by EHD staff at the P.xpense of the applicant Future file reviews by the same applicant may require a$93.00 deposit prior to review. EI16 48-p1-0D6 — �r�<ros