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May. 11. 2007 9: 37AM Aced GeoEnvironmental No. 8568 P. 1 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL$EALTH DEPARTMENT <br /> 304,vast Weber Avenue, 3`d Floor, Stockton,CA 95202-2708 q03 Telephone: (209)468.3420 Fax: (209)464-0138 Web: www.Sjgov.or d <br /> PUBLIC RECORDS RELEASE APPLICATI�O�N p <br /> APPLICANT:p [+ rSC.I BUSINESSIAGENCY:jayianctil AO1VIfb11IYI9I1� <br /> ADDRESS: O J �j Q roce x) JA <br /> 6 ry <br /> PHONE(1): 070- t/b7- rOD� P4ONE(2): O -AA FACSIMILE: ,�A7��� / '� <br /> 14M <br /> TENTATIVE*APPOINTMENT DATE: Time: — <br /> (Please allow 10 business days from date of a II tion submitta(-"7enratrve only-must be confirmed) <br /> CHECK BOX TO EXPEDITE Q5T-596.00 FEE( H OR HECK ONLY)-REQUEST PROCESSED IN 3 BU NESS DAYS <br /> SIG ATURE OF APPLICANT DATE IJ A&Z4 2M <br /> Electronic Information: ❑ List Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City ❑ llnitI- <br /> _ DU 5 <br /> r� 3 330 ,�„ �a ❑ Unit <br /> l/J 3. <br /> 4, Unit 9 O <br /> 6. <br /> Unita <br /> 7. <br /> ❑ Unit 5 lop <br /> 9 1 <br /> S <br /> 10. _ _ — ❑ Unit 6 <br /> Specific Date Range of Information Requested:From to t; ■ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES O <br /> Iy}UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYIVEHICI,E <br /> OTHER CLEANUP SITE MON•LOP) ❑Doc,KENNEL <br /> IY 0 WASTE TIRE <br /> ,r UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> 9+HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Yl TIERED PERMITTED FACILITY ❑MOTE ROTEL PUMPER TRuCKIYARDICHEM TDILM <br /> d MEDICAL ODYWAS PIERCING ❑POOLIOTHER(P0. LAND Use APPLICATION SITES <br /> MEDICAL WASTE FACILITY 13 OTHER(PLEASE$PECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAJLA13LE FOR RENEW- MONDAY-FRIDAY 8:00 AM-6:DOPm - 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 Nle type MUST be selected. Fax to(209)464.0135 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 he confirmed approximately ten(10) <br /> days after receipt of application. The riles 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 he <br /> submitted when the file is available. <br /> 4. Any Nle 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 /> END*." 9/1912006 <br />