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04/24/2007 08:56 5302445021 LAWRENCE ASSOCIATES PAGE 01 <br /> QATIE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTA-L HEALTH DEPARTMENT <br /> ,5:P!•� <br /> 600 E. Main Street, Stockton, CA, 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sJSov,org/ d <br /> "o <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:1,/a rti. �, I /vLt LISINES AGENCY: $ y�C <br /> ADDRESS:_2,.001 rmr tC� 5'f rrrc f � ' �'E�/�I . I �0d 1 <br /> PHONE(1):5Lo—-2 `{`f--a'70 PHONE(2): FAGSIMtLE; S�0 ~Z L( -Soo?� <br /> TENTATIVE'APPOINTMENT DATE: 5-13 MCKCIESSED <br /> �c Cj a qt ,4-- Zp,M- <br /> (Please allow 10 business days from date of appl catlon submltt91-We ust 6e confirmed) f/ <br /> CHECK BOX TO EXPEDITE REQ ST-$95.. CASH OR CH L1"[); Ft IN�3 BUSINESS DAYS G,Ja7-1�jG <br /> SIGNATURE OF APPLICANT DATE 9/2-3J/0 7- <br /> I Electronic Information: ❑ Lis ] Map—Description! <br /> FILL ADDRESS EHD USE ONLY { �� <br /> Street* Street Name City ❑ unit 1 I <br /> 2. 10 U 1{ �, n e� L" I � Unit2 <br /> 3. 105-00 w�r I "° <br /> 4. I �4'�hlC1 "+ ow'Unit3 <br /> $. S'➢`1'�,to t' �' <" <br /> s. ,�� � ��-- war � ., <br /> ie A <br /> 7. I ii 5 tt W�Y I t� ❑ unit <br /> 9. /J <br /> 0. <br /> r i <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> AuNoERGGROUNo TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT f'SOUD WASTE FACIUTYNEHICLE <br /> OTHER CLEANUP SET;(NON-LOP) E3 FOOD FACILITY Z WASTE TIRE <br /> X,UNDCROROUND TANK(MOWTORINOIREMOVAL) C3DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH .121TIYASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑TATTOOIBoDY PIERCING 0 POOLISPA (� 171 LAND l�SE�6*PPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY ,i OTHER(PLEASE SPECIFY) 4 " 46 ve Arc <br /> WELL ANP SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM5:00PM - EXCLUNNO HOUDAYS. <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(2091464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted—for additional assistance with rile 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 t®n(1o) <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 /> Q. Any file not returned in the same condition as released will ba reorganized by El Ib staff at the expense of the applicant, <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> II <br /> - t <br /> EHD 48-" W13120M woo <br />