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Mar, 21. 2006 1 : 12PM Advanced Geo Environmental No. <br /> DATE;DAT1/1osrR <br /> E�a%,csv�u <br /> `.. SAN JOAQUIN COUNTY N.... <br /> L�11 ENVIRONMENTAL HEALTH DEPARTMENT i( <br /> 304 East Weber Avenue,3`a Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax; (209)464-0138 Web:www.sjgo�v,o�rg/ <br /> PUBLIC RECORDS RELEASE?9�O��WMO r. <br /> APPLICANT: u rc d� euIN ' '�' J� t!t , <br /> ADDRESS: r, .J o Q S�Cu.. i 1 ^ '7 <br /> PHONE(1): Q • T b 7"f U©6 PHONE(2): 1) 1d ~I� FACSIMILE..A0 l' 7[C�'/- <br /> TENTATIVE"APPOINTMENT DATE: &( aN ftlartk ;L LI Time: 1M <br /> (Please allow 10 business days from date of ap rcation submittal-*Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE UE8T-$93.00 FEXC H 0 CHECK ONLY)•REQUEST PROCESSED IN 3 B SINES DAYS 5 <br /> SIGNATURI=OF APPLICANT DATE <br /> UNIT DISTRIBUTION ❑ Unit 1 ❑ Unit 2 ❑ Unit 8 ❑ UDIt 4 0 Unit 5 13 Unit 6 ❑ Other(electronlclllatstmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> street A , street Narqp, city <br /> 1. S- <br /> 2. . " RaIRIALMS43 <br /> 3. <br /> 4. <br /> s. a 3qqaa� �6 <br /> 3 f O (7 <br /> 7. <br /> 8. a <br /> 9. N 3 <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> f <br /> NDERGROUNDTANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT E3SOUD WASTE FACILITYNEHICI-E <br /> THER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY C3 WASTE TIRE <br /> NDERGROUNDTANK(MONITORING/ROGEMOVAL) ❑DKENNEL ❑DAIRY <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH t3WASTEWATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKfYARDICHEM TOILETS <br /> t�TATTOWBODY PIERCING 13 POOUSPA ❑LANj2 USE AppkicATION SI <br /> 13 MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY)? n 1 YJ' <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - FXr,11 1114h IN 11 WAYS <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 snail to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications recelved 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 new <br /> application may be submitted when the file is available. <br /> 4. Any fife 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 46-02-006 <br /> 1714!06 <br />