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11-Jan-2006 02:25pm From-Youn$dahl r Itini Group. Inc 916 933 6482 T-232 P.001/001 F-TT9 <br /> T EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTALeberAvenue, <br /> 3 HEALTWo DEW A A 95202- � 1 T <br /> 304 East Weber Avenue,3`'Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:WWw.Sjgov.Org/ebd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANT:� //Y�ar`r� -1"S rQ / _BUSINESS/AGENCY:✓ <br /> ADDRESS: �2 /c�'1-t' <br /> PHONE(1);0110-) 7/�l — �] PHONE(2): yJ / `t"l �"L FACSIMILE" <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> / (Please allow 10 business days from date of application Submittal-•Terdatrm only-must be confirmed) <br /> LH CHECK BOX TO EXPEDITE RE T-$93-00 EE( R CH K ONLY)-REQUEST PROCESSED IN 3 BVSINESS DAYS <br /> SIGNATURE OF APPLICAN DATE <br /> UNfrmsTRIBUTION 4 Unit2 0Unit3 ❑Unit4 ❑ UnitS ❑ Unit6 ❑ Other(oloctronic/lisc;/maps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street! Stmt Name city <br /> 1. /00 Ghar�eP W Since y \\� <br /> 2. 50 1 ChCzi'1'e M <br /> ri v <br /> C4T-t v e <br /> 3 >?r W rr <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 1NDERCRouN0 TANK(VST)CLEANUP SITE(LOP) ❑HOUSING ASATENENT SOLID WASTE FACILITYNEHI E <br /> ��EA CLEANUP SITE(NON-LOP) ❑FOOD FACILITY In WASTE TIRE <br /> J�mc ERGROVND TANK(MONRORNWREMOVAL) 171 Doc KENNEL [71 DAIRY <br /> VHAZA USWASTEGENERATDR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY O MOTI3/HOTEL ❑PUMPER TRUCK/YARD/CHW TOF_EfS <br /> ❑TATTOO/BODY PIERCING ❑PDOL/SPA ❑LAND Use APPLICATION SITES <br /> 13 MEDICAL WASTE FACILFFY O OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTMIT <br /> IC PERRECORDS ARE AVAILABLE FOR REVIEW - MONDAYC-rmDAY 8:00 Am-5:00m - EXCLUDING HOUDA:'S. <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 address <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 new <br /> application may be 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> lMO0➢-02ao6 <br /> +nuns <br />