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Jan 1y U/ 1U:11a Apex • 209957-9668 p.1 <br /> R=N ED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> JAN 2 9 2007 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENT HEALTH Telephone: <br /> East Weber Avenue, 3( 09)4 -013 Won,b: Ww.sjg 2708 <br /> PERMIT/SERVICES Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjgov.otg/eltd <br /> PUBLIC RECORDS RELEASE APPLICATION^ <br /> APPLICANT: Q rtsty oLvN .41U A BUSINESSIAGENCY: ✓-�1�­e,Y <br /> ADDRESS: 3`;LI�c A/. Cd( n ${c�C $(tom., $.1�� e G rur[acK c4 YS38Z <br /> PHONE(1): Z�7 PHONE(2): Zvg6T`e— z7--r2 FACSIMILE: �'T <br /> TENTATIVE•APPOINTMENT DATE: 72.1)-z-1 ,077- Time: G/qC)n <br /> (Please allow 10 business days from date of application submittal-`Tentative only-must be Confirmed) <br /> El CHECK BOX TO EXPEDITE RE VEST•,931.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUST ESS DAYS <br /> SIGNATURE OF APPLICANT -V Jt^ \ DATE rIZQo� <br /> UNIT DISTRIBUTION ❑Unit 1 ❑Unit 2 D Unit 3- ❑ Unit 4 ❑ Unit 5 ❑ Unit 6 ❑ Other(electronicAlstsimaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Streettl Street Name City <br /> 1. 7_ <br /> E- v9K S - S+,O(A --r - <br /> 2. Z 355 V4 o <br /> 3. <br /> 4. 1251- u t 5 9 <br /> 5. 25 `f Low IS IPsI $ Kinn <br /> 6. <br /> 7. <br /> 8, <br /> 9. <br /> 10 <br /> Specific Date Range of Information Requested: From �� to C�✓"/e-�t'I- <br /> ENV)RONMENTAL HEALTH DEPARTMENT FILES <br /> JZQ.UNDERGROUND TANK[UST]CLEANUP SITE(LOP) ❑HOusING ABATEMENT ❑SOLID WASTE FA:nuT NEHICLE <br /> LI OTHER CLEANUP SrrE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> El UNDERGROUND TANK(MONRoRING/REMWAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCK/YARDICIIEM TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITFS <br /> ❑MEDICALWASTE FACILITY - ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMrT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 6:00 AM-5:OOPM - Excuum NG HODDAYs. <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 Tile 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 (i a)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 /> EH 0 Q42406 <br /> W4l00 <br />