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Nov 28 05 03:26p Apex • 2(67-9668 p.1 - R�,RECEIVED T (I I DLOG NUMBER 4�1 V `% I� SAN JOAQUTN COUNTY W- ENVIRoNMENTAL HEALTH DEPARTMENT Ov 24, � ao 304 East Weber Avenue,3I Floor, Stockton, CA 95202-2708 Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehdZ10,3 MiCES PUBLIIC RECORDS RELEASE APPLICATION APPLICANT: vin SUS(NESSIAGENCY: ��r ADDRESS:__ Z� t�i+ge �rlv1. � arl�' tk riS�6L PHONE(1): PHONE:(Z): FACSIMILE Z�1 –16 tt TENTATIVE'APPOINTMENT DATE: I t Tine: W lea (Pse allow 1 D business days from dale of application submittal.•Tentaave onty-must be confined)— CHECK BOX TO EXPMTE RequEST-$93.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESrEDIN 3 gUSI DAYS SIGNATURE OF APPLICANT �1'a^-U ✓6�^�'A� DATE W7.%1'4) UNIT DISTRIBUTION 0Unit1 ❑ Unit2 ❑Unit 3- Le Unit4 ❑ UNt5 ❑ Unit ❑ OrMr(eletbraIrMists(mapa} FILE ADDRESS EHD USE ONLY street a street Name City ,1 1. yo 5 Ma: lL5 5 . o r. c 5 L 5 %X -+ y of reW 6. def 4 tK 6. 0105 1' r�.a • - u a-. 3537 7. -�`l31 3V1 S. sv r $? s Y ae NK Specific Data Range of Information Requested:From Z..py to (-d ty'f./•{- ENVIRONMENTAL HEALTH DEPARTMENT FILES .'SttNDERGRDUND TANK(UST)CLP.ANW SITE(LOP) ❑HOUSING ABATEMENT ❑SOUD WASTE FAC /VEHICLE ❑0` rRCLEANWSRE(NON-LOP) ❑FOOD FACIITY 13 WASTE TWE ❑UNDERGROUND TANK(NOK NGmEMOVAQ ❑DoGKEHas ❑DAIRY ❑HAZARDOUS WASTE GENERATOR ❑CHKEN RANCH ❑WASTEWATER TREATMENT PViNT ❑TIERED PERMnTeo FACILITY ❑N oTeJHOTEL ❑PUMPER TRLKwffARD(Cml TOII.Ei3 ❑TATToOIBODY P�NG ❑POouzpA ❑LAND VSE APPUCAT"SITM ❑MEDICAL WASTE FACUTY ❑OTHER(PLEASES WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RFIIEW- MONDAY-FRIDAY 8:00 AM3:00PM - EXCLUDING HOLtaA 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least 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,contact the EHD.Applications received after 3U0 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 business days for review. Appointments should be scheduled accordingly. 3- A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the fife is available. 4. Any file not 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 nray require a$93.00 deposit prior to review. axes-oz�os vlws