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07/24/2007 11:49 5308871495` BLACKBURN PAGE 01/01 y, <br /> Cl END LOG NUMBER <br /> R� tiv 1`. SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENTov <br /> ,,'!4. 2 4 2007 600 E.Main.Street, Stockton,CA 95202-3029 <br /> I. � S,I r, . ,;_rf Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjg /e <br /> , T; j(E`J; PUBLIC.RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY: <br /> ADDRESS: k6a <br /> e�ia <br /> P14ONE(1): �M. �fi � � 7): A /7y r :—'3��. <br /> TENTATIVE*APPOINTMENT DATE �d� Time: &!I I <br /> (Please allow 10 business days from date o appllc t subrr(Itt -*Tentative only-must be confirmed) <br /> ACHECK BOX TO EXPEDITE REQUEST-$96.0 OR ECK LY)-REQUES;,ZPX_4ATE ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> Electronic Information: ❑ List©Ma Description: <br /> FILE ADDRESSEHD USE ONLY <br /> Street 0 Street Name , Ity ❑ Unit 1 <br /> F2. <br /> . r _ sa <br /> �.�—��`rs�7..!!��...__ ❑ Unit 2 <br /> 3. _ <br /> 4. <br /> 6. Unit 4 <br /> 7. I rj(2(2 <br /> ❑ unit s <br /> 8. <br /> ❑ unit 6- <br /> 10. <br /> Specific Date Range of Information Requested:From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> W IUNDERGROUNO TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> 0 ER CLEANUP SITE(NOWLOP) O FOOD FACILITY O WASTE TIRE <br /> �KGkRGROUND TANK(MONITORINGIREMOVAL) G DOG KENNEL ©DAIRY <br /> iK HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY O MOTEL/HOTEL 0 PUMPER TRUCxNARD/CHEM TOILETS <br /> O TATTOOIBODY PIERCING O POOL/SPA O LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY ©OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM . EXCLUDING HOUDAYS. <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 0 464-0138 or mail tp the address ln0jGated above. Address <br /> ranges will not be accepted–for additional assistance with file addresses,contact the ENC).Applications received after <br /> 3:00 pm will be processed the neaft business day. <br /> 2. The EHD will notify the applicant if any EI-10 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 /> 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$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> s <br /> END40.08 WIVROW Web <br />