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FROM :SALEM Engineering Group, ---nc. FAX NO. :5592750827 1. 12 2010 08:56w P2 I <br /> r.ri "w► <br /> R=N ED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> JUL 1 $ LOlO ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> ENVIRONMENT HEATWone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> q7Z <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: M06�ltiayyva645 �M BUSINESSIAGENCY:� � �/��F�p�rl�e Cjrcu, <br /> ADDRESS: Q S �T <br /> ,,-�n..� ►�� h( 1lt'� CITY/STATE/ZIP <br /> PHONE(1): PHONE(2):_55% 271-9`70C) t=ACSIMILE:W��--�2 <br /> TENTATIVE*APPOINTMENT DATE; '7_ _ /.O - — Time: 100 ��� <br /> (Pleaso allow 10 businoss days from date of ap Ilcatlon suUmittai-*fWiaBvv only_-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST FEE(CASH OR CHCC ONLY) EQUE:S PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE...._. <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> (� <br /> -- - lJ <br /> Street# Street Name City ❑unit 1 <br /> 1. _...._ K00'.& _.... ..W <br /> 2. —Unit 2 <br /> 3. 16 _/,\ <br /> 4. - <br /> �.._ Unit 3 <br /> 5. <br /> 6. <br /> _ <br /> Unit 4 <br /> C7 <br /> 8. <br /> ---- _.___._..._......... _......._...- -..__...----- Units <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> speclfic Data Range of Information RequoOted: From q q Q _ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILETS <br /> [ GNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICI.F <br /> ❑OTHER CLEANUP SITE(NON-LOP) ©FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ©DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PFRMn"I'EU FACILITY ❑MOTELJHOTEL ❑PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITCS <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARF_AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uD to ten addresses in the space above. Select the type(e)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fal(tp(2091464-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be 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(10) <br /> days after receipt of application, The files will be held 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 roviow. 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 some applicant may roquiro a$116 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)469-3425. <br /> ONLY <br /> .,.�,. _—____............ . ......._...___..... <br /> EHD 48-06 <br />