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01/09/2008 15:01 209334537,; WGR SOUTHWEST NOCAL PAGE 01/01 <br /> DATE RI=C ,Ep_ ( r- <br /> L s.,�� �' SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPA,RT'V)(ENT <br /> !N 1 0 2Q08 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web. www.sjgov.cr e <br /> INV! ii!�IMF"N?' HEAD <br /> - PE ',A1T/SLE-) Z7 <br /> /!( r-t PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: I Ry �— 5-H <br /> -EBUSINESS/AGENCY: CJ C, <br /> ADDRESS: nnI W t✓ S 1 'C r U l T4 LO D�L <br /> PHONE(1): 3 Jt1 J�3(e3 PHONE(2): o <br /> • FACSIMILE:IO9 --it y <br /> TENTATIVE*APPOINTMENT DATE: � 2 <br /> (Please allow 10 business days from data of application submittal••Ten(af/ve only <br /> nly-must be confirmed) <br /> Q CHECK BOX TO EXPEDITE REQU ST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 B/USINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE / Q <br /> Electronic Information: [J List❑Map'-Description: <br /> FILE ADD /EHD USE ONLY <br /> i{ Street Name � <br /> Street <br /> l 5city1. 0.V w c 2�� G��71 � I © unit) <br /> 2. 35c�5 CSV <br /> 4. I�t�� 16 �—c15�D31 v quo QS Unit2 <br /> 5. uV IY �� 3 ��VU► ' lMrs4 fVC-) C Unit <br /> 6. <br /> a� <br /> 7. � RAF•a ��\ <br /> ❑ Unit5V u <br /> 9 <br /> 10. I Unit 6 <br /> jr <br /> Specific Date Range of Information Requested:From <br /> to <br /> a< <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> aNDERGROUND TANK(UST)CLEANUP SITE LOP ,,,,,,//"" <br /> THER CLEANUP SITE(NON-LOP) ( ) ❑HOUSING ABATEMENT —' <br /> FOOD FACILITY <br /> �VALID WASTE FACILRYNEHICLE <br /> UNDERGROUND TANK(MONITORING/REMovAL) ❑ 0 WASTE TIRE <br /> HAZARDOUS WMTE GENERATOR DOG KENNEL 0 DAIRY <br /> C'TIERED PERMITTED FACILITY CHICKEN RAHCH 0 WASTEWATER TREATMENT PLANT <br /> 1�)TATTOO/BODY PIERCINO MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> 0 MEDICAL WASTE FACILITY ❑POOL/SPA 0 LAND USE APPLICATION SITES <br /> 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEP' C PERMIT RECORDS ARE AvAILARLE FOR Rrmcw -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 /> ran(es). At)Babe one fife type MUST be selected. Fax t 20 464-013 or mail tothe address Indicated above ddress <br /> ranges will not be accepted–for additional assistance with file addresses,contact the EHD. !IApplications received after <br /> 3:00 pm will be processed the next business day. <br /> HD <br /> ll notify the <br /> If any EHD files exist. An appointment for review <br /> 2. days after riecelpt of application.applicant The fl es w II be held for a maximum of fiv bus n business d e confirmed approximately ten(10) <br /> days for review. Appointments <br /> 3. A file that is actively being worked on b EHO staff may not be immediate) available for review. A new a <br /> submitted when the file is available. y y y <br /> application may be <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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHDo� <br />