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Ju1. 13. 2006 2:53PM Adced GeoEnvironmental No. 5480. P. 1 <br /> DATE k>:cErotU =HD Lv�,..UMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3r1 Floor; Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT!._1 V 11 en <br /> �+ 1/ BUSINESS/AGENCY: <br /> ADDRESS: „„AA (y S ' O Q J�/�r I I .t 1% �) n e I -�j <br /> PHONE(1): �iG 6 / - I �O / --f UO& PHONE(1): D 7 /I� r1/�- 1`2f FACSIMILE: GSD <br /> TENTATIVE°APPOINT89ENT DATE: I R JO �� d040(n eweJ) Time: 6 r-(�b�iA��('EaA� <br /> (Please allow 10 bus!noes;days from date of application submittal-'Ten_1 ti ve only-must be confirmed) Ir <br /> 4�CHECK BOX TO EXPEDITE R E,ST•$93.00 FEE(C OR C,VErtCK'ONLY.-,REQUEST PROCESSED IN 3 B SINE5^DAYE•��-� <br /> SIG OF APPLICANT f� �l�s tJ L DATE <br /> UNIT DISTRIBUTIOtI 0 Unit EfUnttz M Unit O Unit IM Unit 0 Unit :1 Other(electronlc/llst5/ITI <br /> FILE ADDRESS EHD US ONLY <br /> Street E Street Name Ci <br /> 1. ua — a - <br /> 2. It n it ttwl 15W <br /> 3. t9 It rt t U <br /> 4. <br /> 51 a �_ 't D <br /> 8• ra t c <br /> 81 gi r, RI PLK <br /> 9• e� tr � <br /> 10. O m V� l l` <br /> 00 <br /> peGfic Date Flange of Information Requested: From DD ti to <br /> n C�TIE D'�1L1 ENVIRONMENTAL HEALTH DEPARTMENT FILES — 'S ' <br /> UNDERGROUND TANK(US'!)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT O SOLID WASTE FACILITYIVEHICLE <br /> DTHER CLEANLip$RE(HON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ND.RI21=0 TANK(MONITORINGIREMOVAL) M Doe KENNEL Q DAIRY <br /> HAL1RbDU$WASTE OENaPArpR ❑CHtOKEN RANCH 111 WFO. EWATER TREATMENT PLANT <br /> d TIERED PERMITTED FACILITY 13 MOTELIHOTEL �U PUMPERTRUCK/YARDICHEM TOILETS <br /> 13TATTOO/SooY PIERCING ❑POOLISPA 7a LAND U8E APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) /_' <br /> _ WELL MID 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 <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2081464-0138 or mall to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses, contact <br /> the EHD.Applications recel'vE after 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 <br /> approximately ten(10) days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is 1Ctively being worked an by EHD staff may not be immediately available for review. A new <br /> application ibay be Submitted when the file is available. <br /> 4. Any file not returned in the,ame condition as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> Eno eaaz.00a <br /> W140 <br />