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_D ff ED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> NoV 12 2008 600 East Main Street, Stockton, CA 95202-3029 0 <br /> cc Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/eh <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Joseph Bagley/Jesse Berumen BusINESS/AGENcY: Bagley Enterprises, Inc. <br /> ADDRESS: 2370 Maggio Circle, Unit 4 City/State/Zip Lodi, CA 95240 <br /> PHONE (1): 367-4800 PHONE(2): 329-0582 FACSIMILE: 367-5424 <br /> TENTATIVE"APPOINTMENT DATE: NOV 20, 2008 Time: 10:00 <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$1 5 FEE(CASH OR CHECK ONLY -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 1 �- 4%' ' i DATE 11/10/08 <br /> Electronic Information: 0 List ❑'Map-:L'Description: <br /> FILE ADDRESS (_HRU$E ONLY <br /> Street# Street Name City '*sQQ AD ❑ Unit 1 <br /> 713 N. ElDorado Street Stockton U51 NvJ 0(f s ' <br /> 2. ❑ u it 2 <br /> 3. <br /> 4. Unit 3 <br /> 5. <br /> - it Unit 4 <br /> 6. <br /> 7. ❑ Unit 5 <br /> 8. <br /> 9. <br /> ❑ unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR 11 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY r]MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> 171 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVALLABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:00PM -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). 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 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 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> .i4 Iwo,S <br /> l <br /> 8 0 - 1Y1 Wjhj �) <br /> EHD 48-06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />