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01/23/200L 15:20 FAX 1 209 234 7727 STOCKTON f�j001 <br /> DATE RECEIVED DID L03 NUMBER <br /> SAN TALJOAHF V COUNTY A <br /> ENVIItONMENTAL AEALTIi DEPARTMENT �v[ <br /> 304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 4z 17 5 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sj ov.or ehd <br /> �UU6 AN 23 Ph 3: 48 <br /> t / <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: x,7_1-[t 4 171A&C, / BUSINESSIAGENCY:t.I_p ��L ,7"E 'SSOC10.�G5 <br /> ADDRESS: 3N 10 011 S 140-140%MQ,- tX4;4E ." 1 GI} 'K7 )`Y <br /> PHONE(1): jf2o9)S- ,4 -3--42-Z PHONE(2): /gIb)0*1-49055_ FACSIMILE: CZIDrt 'Z- 'L� <br /> TENTATIVE*APPOINTMENT DATE:_- Time: <br /> (Please allow 10 business days from data of application submittal-'Tentative only-must be confirmed) <br /> 171 CHECK BOX TO EXPEDITE REQUES $93.00 FE (COR HECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT RC_ DATE 2 0 <br /> UNIT DISTRIBUTION UnUll 17 Unit2 DUnit 3 ❑Unit 4 13 Unit 5 OUnit 6 O Other(electronlWlists/maps) <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street 0 Street Name __ City <br /> — <br /> 3. <br /> 4. <br /> 6. <br /> 7. <br /> 8. <br /> 9 -ri _ <br /> Specific Data Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> p'UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑$OLID WASTE FACILNYfVEHICLE <br /> OTHER CLEANUP SrrE(NON-LOP) 0FOODFACIUTY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVALI 0 DOC KENNEL 13 DAIRY <br /> W14AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH M WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRIICKIYARWCHEM TOILE'ts <br /> 13 TATTOO/BODY PIERGNG ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> 11 MEDICAL WASTE FACILITY M OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW- MONDAY-FRIDAY 8:00 AM-6:00PM - 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 <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the ad cress <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHD.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(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments 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 nzw <br /> application may be submitted when the file is availahle. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EHD 4442-0 <br /> lnaos <br />