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06/27/42006 10:53 FAX �1002 DATE RECEIVED EHD LC%G NUtWB R SAN JOAQUIN COUNTY ENVTP.ONW,NTAL HEALTH DEPARTMENT 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-27080 Telephone: (209)468-3420 Fax:(209)464-0138 Web: Ayv-w.sjgov.orelefid s, PUBLIC RECORDS RELEASE APPLICATION APPLICANT: f� �iz-.AG BUSINESSIACENCY: MIA_�Al - ADDRESS: �� _JMIJAIIAH Ir LAK) L11 1 6 710g5y ' m ck G.51-tq — PHONE(1):L.U9IM11-- e_PHONE(2): FACSimil_E: TENTATIVE`'AFPOINTMENT DATE: Time: (Picric allow 10 buslncss days from date of application submittal-'Tentative only-must be C>WIrmad) © CHECK E10X TO EXPEDITER U -$93.07FE (CR HECK ONLY),REQUEST PROCESSED 1113 BUSINEDAYS l l SIGNATURE OF APPLICANT DATE _� 'Z S UNiT DISTROF3lUl0�lT- ❑ Unit Unit ❑Unit 3 D Unit4 ❑ Unit S ❑ Unit 6 (7 Other(sfoctronic111stsIrnap c) FILE ADDRESS EHD USE ONLY Strutt it i- Scree`Name _ City_ 4. A 7- _ t M p — - L — -... 0. ��—'•'q--- -- AIt�tME�?-- 5_'Cnt�[xl:�_ -- 9.1D. - Specific Daae Range of Information Requested:From to ENVIRONMENTAL HEALTH DEPARTMENT FILES UNDERGROUND TANK(UST)CLEANUP SUE(LOP) ❑HOUSING ASATEMENT ❑SOLD WAS-TE:FA(XLITYAT tcLE OMER CLEANLIP SITE(NON--OP) ❑FOOD FACILITY ❑WASTE TiRE UNDERGROUND TANK(iAONITO�INUIREWOVAL) G DOG KENNEL ❑DAIRY HAZFjWous WASTE GENERATDR ❑CHICKEN RANCH ❑WAST1WATER TRaAimENT PLANT ❑TIERED PERMITTa_D FACILnY Q MOTEUHOTEL ❑PUMPI-R TRucK/YARJ/CiiEtA TOIL"5 a TATTOOI84DY PIRCING D POOLiSPA ❑LAND USE APPLICATION SITES CJ i4EDICAL WASIE FACILITY ❑OTHER(PLEASE SPECIFY) 'NELL AND SEPTIC PERMrr RECORtx APE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM4:00PM - EXCLUDING HOLIDA'M I. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking Lte appropriate box(es). At feast one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address ranges will not be accepted-for additional assistance with file addresses,confzct the EHD,Appllcationw received;after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10)days after receipt of application. The files will be held for a maximum of five tau€iinesq days for review, Appointments should be scheduled accordingly. 3. A file that is actively being wonted on by EHD staff may not be immediately available for review. A new application may be submitted when the file is avallable_ 4. Any file nat returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant- Future file reviews by the same applicant may require a$93.00 deponit prior to review. Elio MZ,7-06 1114V6