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07/02/2007 10.' 16 FAX _ 001/001 <br /> DATF RECEIVED EHD LOC NUMEiCm <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTII DEPARTMENT <br /> 600 E. Main Street, Stockton, CA 9.5202-3029 <br /> i1 11 } "007 Telephone: (209)468-3420 Fax: (209)464-013$Web: www.sjboV.orgT7/ <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> AWF'•LICANT rT�T_/ R�-LZ BUSINESSIAGENCY: Q E LIQ �A+1 alt L I'19�vf'� <br /> ADDRESS: A I/6 k C,-vL1� Pa vl`/ /2pi-j ( cospovj 4%7o( y�V�+ <br /> PHONE(1):_7�y ✓O l ZG�J PHONE(2): 'FIG -34.6 <br /> IJFA � FACSIMILE: Il 9 D 3� C� Jp J <br /> TENTATIVE"APPOINTMENT DATE; 1 r ,e Time:_4 N Y <br /> submi <br /> (Please allow 10 business days from date of applicationttal-'Tentative only.must ba confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST- 5-00,F E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE -7— /-0 7 <br /> Electronic Information: ❑ List❑Map—Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> straei>f Street Name City 7❑ Unit 1 <br /> 1. �65�0 <br /> M/trrpfr►I'rr (W2. - s L-,T 1 H'Z0l - tea C� ❑ Unit2 <br /> 3. 16420 C.4 M IS(z 10 44 <br /> �_/Me6P <br /> 4 T - <br /> 50 /J - �L-- DU�. `�7; S 1 0C.lL!`001 , �a Unit3- <br /> S. 6u 6 7�-iu2,vro_� t2o. uc—( Dr. _ \ <br /> 7 6. 2_5_5 TailCY /3L%tb. !J Unit <br /> 7. <br /> ❑ Unit 5 <br /> 9. <br /> 10. . _..... ..__ - - — ❑ Unit 6 <br /> Specific Date Range of Information Requested:From L�- to 4 LQ <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> 6NDERGROUND TANK(UST)CLEANUP SITE(LOP) n HOUSING AeATEMENT 0 SOLID WASTE FACILITY/VEHICLE <br /> E4THER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY rl WASTE TIRE <br /> NDEROROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑DAIRY <br /> VAZARDOUS WASTE GENERATOR M CHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELIHOTEL ❑PumFER TRUCK/YARD/CHEM TOIL <br /> O TATTOWBODY PIERCING d POOLISPA rl LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL ANh SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - 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 09 464-0139 or mail tot <br /> he addressindicated 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 /> submitted when the file is available. <br /> 4. Any file not retumed 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 /> EHD 48-06 W3/20w web -- •— - —_ .,� <br />