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01/09/2008 15:01 2093345374 WGR SOUTHWEST NOCAL PAGE 01/01 <br /> DATE F�C�UE — <br /> �CE UD SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL I-IEALTH DEPARTMENT <br /> IAN 1 0 2003 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)4640138 Web:www.sjgov.or <br /> I IV! iil�!N1i=N1' HEA'Llr <br /> Z7 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: i t�� � �+4(�4, <br /> BUSINESS/AGENCY: 60 G, a_)U_FH V)9_S(-- <br /> ADDRESS: ,-:;I:! vJ . Nt., 5 Ree> u t'Z" 4 o D C <br /> PHONE(1): �JLI� .S,��d� PHONE(2): � <br /> FACSIMILE-a L) j L/ 15 <br /> j3 y <br /> TENTATIVE*APPOINTMENT DATE: -'7/, _ <br /> (Please allow 10 business days from data Of application aubmlttal-'Tentaf/ve only-must b a co�ed) <br /> CHECK BOX TO EXPEDITE REQU ST-598.00 FEE(CASH OR CHECK ONLY -REQUEST PROCESSED IN 3 BSINES)S DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE Q <br /> Electronic Information: 0 List❑Map—Description: <br /> FILE ADDRESS <br /> Street iF Street Name EHD USE ONLY <br /> City <br /> ,. 5 15 a.v the a <br /> Unit 1 <br /> z. 9 °3 crit}r- ��!(r,C� <br /> 3. L1 Unit 2 <br /> Q�_bl1z� 2o� c. -> .� - 1U0 C (�s <br /> �. 3 { t' ' c'� C Unit 3 <br /> 6 �. � <br /> . } <br /> 7. \ <br /> 8. - <br /> ❑ Unit s <br /> 9. <br /> 10. Unit 6 <br /> Specific Date Range of Information Requested:From <br /> to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> <NDERGROUND TANK(UST)CLEANUP SITE LOPHER CLEANUP SITE(NON-LOP) ( ) ❑FOObIFACILnY NG EMENT ,,,/LID <br /> PIAST WASTE FACILRYNEHICLE <br /> �NDERCROUND TANK(MONrrORING/REMovgL) En DOG KENNEL ASTE TIRE <br /> HAZARDOUS WASTE GENERATOR ❑DOG KECHICKEM DAIRY <br /> �TIERED PERMITTED FACILITY RANCH 0 WASTEWATER TREATMENT PLANT <br /> M TATToo/BODY PIERCING ❑MOTEL1HOTEL 17)PUMPER TRUCK/YARD/CHEM TOILETS <br /> MEDICAL WASTE FACILITY M POOL/SPA O LAND USE APPLICATION SITES <br /> OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE POR Review - MONDAY-FRIDAY 8:00 AM-5:00pM - EXCWDING HOLIDAYS. <br /> 7. List up W ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> box(es). At least one file type MUST be selected. Fax t 20 464-013 or ail t the addr ss I dice d ov <br /> appropriate <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after Address <br /> 3:Oo pm will 6e 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(70) <br /> days after receipt le application. The flies will be held fora maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHb staff may not be immediately avallable 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 well 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 /> E46-0c ,D OranOD7 <br />