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11/01/2007 15:38 FAX Z002 <br /> p <br /> LIM VEC,0 EHD LOG NUM6ER <br /> SAN JOAQUIN COUNTY <br /> NLJV Q 1 2007 ENVIRONMENTAL HEALTu DEPARTMENT <br /> 600 East Main Street, Stockton,CA S 95202-3029 <br /> ENVIRC}t KIENT HEALhlephone:(209)468-3420 Fax: (209)464-0138 Web:www.$)go <br /> �-" . /eh <br /> PFRPJIIT/SF�iVICE <br /> y� PUBLIC RECORDS RELEASE APPLICATIO <br /> APPLICANT: r t7 1 � AQ BUSINESSIAGENCY. <br /> ADDRESS: / ' .101 y S 5V �� 'a-909 LZ ANAV-� GI'yv q-I <br /> PHONE(1): (���� y7)— JI PHONE(2):: FACSIMILE: a y �d <br /> TENTATIVE*APPOINTMENT DATE: f"V W� r O�"� Time: <br /> (Please allow 10 buslness days from date of application submittal-'Tentative only-must be confirmed) <br /> kCHECK BOX TO EXPEDITE RLQUESTf REQUEST90. FE G OR CHEC (ONLY)-REQUEST PROCESSED IN 3 B SI ESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information; ❑ List❑Map- crlptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City ❑ Unit 1 <br /> ST, E.SCALVN <br /> 2 ❑ Unit 2 <br /> 3. <br /> 4. Unit 3 \\ <br /> 5. 4 <br /> 6. <br /> 7. ❑ Unit 5 <br /> 9. s ❑ Unit6 <br /> 10. IR <br /> J TW Specific Date Range of Information Requested:From - U7 � o M <<- aid <br /> ,,( ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �LyXS UNDERGROUND TANK(UST)CLEANUP SrrE(LOP) 11 HOUSING ABATEMENT 13 SOLID WASTE FAC IutYNEHICLE <br /> p�OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY Q WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH t3 WASTEWATER TREATMENT PLANT <br /> 173 TIERED PERMITTED FACILITY 0 MOTEL/HOTEL ❑PUMPER TRUCK/YAr•'.DICHEM TOILETS <br /> 0 TAT oolBODY PIERCING 0 POOUSPA ❑ LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAlLAI3LE 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> RHD 48-08 wee a/a/2007 <br />