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10/02/2008 10 17 FAX Fa 001/001 <br /> DA SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCT 14, 2008 600 East Main Street, Stockton, CA 95202-3029 Jxv <br /> ``'' JTelephone; (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> kT Irri LTYJ <br /> PFRd�/iiT/S,MV1iJES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESS/AGENCY: <br /> ADDRESS: /� CltylStatalzlp IP o <br /> PHONE(1): '-7 PHONE(2)• FACSIMILE:j r1�/1 a Ll g1-/.'3 <br /> TENTATIVE"A lO busME s(lay Time,-m 1 Ll�_ <br /> (Plea6e allow 10 business day fro date of apps lion submittal-'Ten(ative only•must b ceMlrmod) <br /> r7I CHECK BOX TO EXPEDITER QU - 06 FEE GAS R ONLY)-REQUEST PROCESSED IN S BUSIN S DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electroniclnforrnation. [] List Map—Descripton; <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name cityIt 1 <br /> [4, <br /> Q <br /> Unit 9 <br /> 6. �a / )2.6e29)D Unit <br /> 6 2 Y <br /> �• 1 ` - rNIE Units <br /> 9. Lylp <br /> unit6 <br /> 10. oa t44 <br /> 94E folyll <br /> Specific Date Range of Information Requested: From j 110 to ]�(e5en <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> tADERGROUND <br /> TANK(UST)CLEANUP S ITE(LOP) 0 HOUSING ABATEMENT LID WASTEFACILITYfVEHICLE <br /> HER CLEANUP SITE(NON-LOP) Q FOOD FACILITY TE TIRE <br /> OERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL AIRY <br /> ZARDOUS WASTE GENERATOR ❑CHICKEN RANCH STEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY 13 MOYEL/HOTEL MPER TRUCKIYARD/CNEM TpILETS <br /> YAT700IBODY PIERCING M POOUSPA NO USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY M OTHER(PLEA9E SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 0:00 AM-6:00PM -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(*)of files from the list above by checking the appropriate <br /> box(as)- At least one file type MUST be selected. Fax to(209)464.0138 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 attar <br /> 3:00 pm will be processed the next business day, <br /> 2. The EHD will notify the applicant if any EHD blas exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be hold 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 be <br /> submitted when the file is available. <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$106 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 4"6 0104MB PUBLIC RECORDS RELEASE APP FORM <br />