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"03/10/2005 15:44 FAX 510 420 91.70 CAMBRIA @001 M <br /> EHD LOG NUMBER <br /> # SAN JOAQUIN COUNTY <br /> MAR � 4 2 45 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor, Stockton, CA 9S202-2708 <br /> I ENVIgo NhAENT HEA TYlelephone:(209)468-3420 Fax: (209)454-0138 Web:www.sjgov.orglehd <br /> PRlITJSE�VCS PUBLIC RECORDS RE k <br /> LEASE APYLY it ATIUN ] <br /> APPLICANT:__. 1_t)fsraA „E��,K ., , ...___.. BUSINESSIAOENCY: �fUS . <br /> ADDRESS: D v <br /> { PHONE(1):_[s t a 4ao- !j&'rJ f PHONE(2):ISI D]Ko n-t7'AQ I FACSIMILE: jCjo 7 Nt b 9176 <br /> TENTATIVE*APPOINTMENT DATE:a.ZA.RA, !� Time- L0,¢ 6f6 I <br /> (Please allow 10 business days from date of application submittal-*Tentadve my-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST.$93,00 FEE(CASH OR CHECK ONLY)-I REQUEST PROC15SSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _ I) I DATE rn•- <br /> 3 <br /> UNIT DISTRIBUTION 0 Unit 1 O Unit 2 Unit 3 Unit 4 © unit 5+ C] Unit 6 In Other(el9ctrontcflistslmaps) <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name City 'I <br /> [4. <br /> Da.� r P0 A 9 <br /> . <br /> 7. <br /> 8. <br /> 9. # <br /> 10. <br /> Specific Date Range of Information Requested: From ��QQ_ i ipfo <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> "()NDERGROUND TANK(UST)CLEANUP SITE(LOP) Cl HousING ASATI=MENY I 0!SOLID WASTE FACiLITYNEHICLE <br /> �/ ER CLEANUP SITE(NON-LOP) 1_7 FOOD FACILITY ❑'WASTE TIRE <br /> ;NDERGROUNDTANK(MONITORINGIREMOVAL) ❑DOG KENNEL ik MIDAIRY <br /> HAZARDOUS WASTE GENERATOR n CHICKEN RANCH 0:WASTV;WATER TREATMENT PLANT <br /> 17 TIERED PERMITTED FACILITY d MOTELIHOTEL �I C3 PUMPER TRUCKIYARDICHEmToiLETS <br /> 13 TATTOo1BODY PiERCINO 0 POOLISPA iP 0 LAND USE APPLICATION SITES <br /> D MEDICAL WASTE FACILITY 17 OTHER(PLEASE SPECIFY) } <br /> WELL AND SEPTIC PERM;T RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8-o0 AM-5-00M - 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 <br /> appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mall to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the END.Applications received after 3:00 pm will be.processed the next business day. <br /> 2. The END 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. I <br /> 3. A file that is actively being worked on by END 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 reorganixed�lby END staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$,93.00 deposit priorto review. <br /> ,t <br /> { ERV 48-02-006 <br /> 7114706 <br /> �f <br /> I3 <br /> I � <br />