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Jul. 13. 2006 2:53PM A0ced GeoEnvi ronmental 0 No, 5480. P. 1 <br /> DATE ktt/EIVEq SAN JOA(�UIN COUNTY cND Lv�,,vUiif9ER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd door,Stool on,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ® PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 60 BUSINESS/AGENCY: C LA - e <br /> ADDRESS: tt//� s/� /.�,y /�j r� !J /�p <br /> PHONE(1): - 7 C!7 f n i UQ�& PHONE(2): Q 7 "/ //� 2/A_ '/ f FACSIMILE: U (" e l!�7 r <br /> TENTATIVE*APPOINTMENT DATE: �� Ju Ly �®Q(� C T T.. 110-'O'o <br /> (Please a8aw 10 buainess days from date of application submittal--Tentative only-mu$I be confirmed) �s t re_a O <br /> CHECK 80X TO EXPEDITE:�����CVECK ONLY)-REQUEST PROCESSED IN�3g B INES DAYS <br /> SIG ATURE OF APPLICANT DATE / d <br /> UNIT DISTRIBUTION 0 Unit 1 IfUnft 2 a Unit 3 0 Unit 4 ®Unit 5 13 Unit 6 M Other(elactroniclllstchaps) <br /> FILE ADDRESS EHD ESS ONLY <br /> street 9 Street Name Ci <br /> 1. <br /> '409OAR <br /> 2. tt r+ tP tt <br /> 3. G`1 to et r le <br /> 4. <br /> 6. >st <br /> 7. L <br /> g. ate" ee sR <br /> 3 pecifie Data Rama of Itlform stion Requested:From to <br /> `. ner-T(e 0^4.1 ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E3 HOUsm ABATEMENT 13 SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANuP SITE(NON-LOP) a FOOD FACILITY 0 WAATE,Tose <br /> NDERGROUNO TANK(MONiTORINC4REFAOYAL) A DOG KENNEL Q DAIRY <br /> HAZARbovo WASTE GENERATM M CMOKEN RANCH 13 WAZ;'MVATMdt TREATMENT PLANT <br /> d TIERED PERFArr m FACILITY 0 MOTELIHOTEL Q PUMPER TRUCWYARDICHEM TOILETS <br /> ❑TATTOCYBODY RERCtNG ❑POOLISPA LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MoNDAY-FRIDAY 8:00 Am-5:4QPM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of fifes from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to 12091464-0138 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 END 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 neve <br /> application day be submitted when the file is available. <br /> 4. Any file not returned in the sante condition as released Y411 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 /> ,.fir•„- <br /> EiiO 4eAT.eQ6 <br /> W114 s <br />