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PLTE RECEIVED -� u LUG NUMtstK <br /> er+`� SAN .IOAQUIN COUNTY � <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> dt "� 600 East Main St. Stockton, CA 95202_3=0A Y <br /> Telerhone: (209) 468-3420 Fax: (209) 464-0138 Web: rg/eh <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: t0 BUSINESSIAGENCY: 1= 9 Zc0 Z(o <br /> ADDRESS: 352 ug • ZOO CITYISTATEIZIP: 1 1b}a M eS&,� <br /> PHONE(1): - - 3 PHONE (2): �5Ilei - ?IS 2FACSIMILE:510-2cl5 - 265�, <br /> TENTATIVE*APPOINTMENT DATE: r (~✓ 2 - o 1 O Time: $q <br /> (Please allow 10 business days from date of applicaUo submitta `Te tadve only-must be confirmed) <br /> CHECK BOX TO EXPEDIT DUE -$115 F_QQASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU (NESS AYS <br /> SIG TURE OF APPLICA DATE (g 25 1 <br /> Electronic lnfortnation: (I List M tp- cript n: _AdLtmfi rovime J On <br /> FILE ADDRESS EHD USE Olik Y <br /> Street# Street Name City Unit 1 <br /> 1. 23 0 t�Slri� u2. <br /> 2. <br /> it_ <br /> _Un2 I <br /> 3- q42- <br /> s I� <br /> 4. Q Ck Unita <br /> ve-6s. 3 X 51, Sp 1-DC �-0 1 Ave- <br /> 6. <br /> . 21 W IvI� I S'1 , —_ Unit 4 <br /> 7. 11 I t�o\� <br /> 8. 2 0 I+ 9 �? <br /> -1-� � ❑Unit 5 <br /> 10. Its 2n <br /> unit 6 <br /> Specific Date Range of Information Requested: FromQ r toi7r.ese <br /> ENVIRONMENTAL ALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY E]WASTE TIRE <br /> fS�l1"�NDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH <br /> _ jilPUMPEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY <br /> ❑MOTEL/HOTEL MPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTooIBODY PIERCING ❑POOLISPA <br /> ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY <br /> ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un 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 /> 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$115 deposit prior to review. <br /> S. If you need further assistance, please contact Diane Martinez,at(209)468-3425. <br /> EHO USE ONLY <br /> END 48-06 <br />