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04/11/2005 09:08 209-57 25� 1+10DESTO ATC ^/ PAGE 02 <br /> EHD LOG NUMBER <br /> DATE RECOVED SAN JOAQUIN COUNTY <br /> A"lil 11 ENVIRONMENTAL HEALTH DEPARTMENT RUSH <br /> R V 304 Frost Weber Avenue,3 Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax;(209)464-0138 Web: WAi'Ttotweb�� <br /> PUBLIC RECORDS RELEASE APPLIC T N <br /> j- <br /> APPLICANT: K Bu�t+eMA V1���9�ls�tj: <br /> a., o G CI rte'A X I fitu I -- � <br /> ADDRESS: I w+ Leti I�a1a. Ave S . <br /> PHONE(1): S-4 ct --21-ZI PHONEf(2): FACSIMILE: U�-577•�ZZr <br /> TENTATIVE'APPOINTMENT DATE: "r- -a s ��: <br /> (Phase aoow 10 busineas days from data of application submittal-*TentsttV0 only-must M colTflrmed) <br /> CHECK BOX TO EXPEDrm REQUEST-$03.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION in Unit 1 r3 Un t 2 C3"3 93 Unit 4 13UrJt 9 n Unit 6 Q Other(ehthonlcRl fth"pe) <br /> FILE ADDRESS EHD USE ONLY <br /> &ked d Street Name city <br /> 2, IR L�. Ct,sv W, � S�rck�►a ' <br /> s �,�r <br /> 3. tYl / <br /> 4. 2005 0 - <br /> cog <br /> S4•.. a I k <br /> Ail, <br /> �. r 1 <br /> 10. <br /> to <br /> Specific Date Range of Information Requested: From —y <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> D HOUSING AaATEMENT 0 SOM WASTE FAC;LMIVENICLE <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) o FOOD FACILITY p WASTE TIRE <br /> OTHER CLEANUP SITE(NON-LOP) G FOOD KENNEL O DAIRY <br /> UNDERGROUND TANK(MONITORD41REMONAL) fl coo KEN RANCH E3 WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR, O CHII I RAN 0 PUMPER TRUCKIYARDICHE1!TOILETS <br /> TIERED PERAtITTEO FACILITY 11 POOLISHO C LAND USE APPLICATION SITES <br /> PA <br /> 13 TATTOOIBOOY PIERCING G OTHER(PLEASE SPECIFY <br /> 0 MEDICAL WASTE FACILITY <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY•FPJDAY 9:00 AM-5:00PM E7ICLUDINO HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of tiles from the list above by checkindress <br /> g the ! <br /> 138 or all <br /> appropriate bee. A At least one flwill no type be ac eptedQ ford additional assistance with file11 464-0' ito MLAq <br /> addresses,contact <br /> Indicated above. Address ranges <br /> the END.Applications received after 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. <br /> approximately ten(1(1)days after recelpt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. Afile that Is actively being worked n the bfiley <br /> stat mablay not be Immediately available for review. Anew <br /> application may be submitted at the <br /> 4. Any file not returned In the same condition as released will bereorganized <br /> a a93f00 deposit riorRto reviawPense of the <br /> applicant. Future file reviews by the same applicant may req <br /> END 16�-006 . <br />'i <br /> I M M6 <br /> I� <br />