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07/14/2006 17:05 4640138, ENVIRONMENTAL HEALTH PAGE 01 <br /> %..i SAN JOAQU IN COUNTY ...a <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor,Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATTON <br /> APPLICANT: BUSINESSIAGENCY: <br /> ADDRESS: <br /> PHONE(T): 4JPo Em-; O 7 - ��`� FACSIMILE "` r <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE RE T.$93.00 FEE(CASH <br /> OR CHECK ONLY)-REQUEST PROCESSED IN 33 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ��`- DATE C �' <br /> UNIT DISTRIBUTION Unit 1 .0 Unit 2 0 Unit 3 0 Unit 4 ©Unit 5 L7 Unit 6 0 Other(electronlclltst$1maps) <br /> FILE ADDRESS EHD USE ONLY <br /> Suvet# Street Name City <br /> 1_ <br /> 2. <br /> 3. <br /> 4. <br /> 5. a <br /> 6. <br /> 7. <br /> specific Date Range of Information R 8 d:From ��OZ to <br /> --- — "- -- - ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDEROROUND TANK(UST)CLEANUP SITE(LOP) EI HOUSING ABATEMENT 17 SOLD WASTE FApLIrYNEHICLE <br /> 17 OTHER{CLEANUP SITE(NoN-LOP) 0 FOOD FACILITY ❑WASTE 71RE <br /> E7 UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR to CHICKEN RANCH 0 WASTEwTRU �EATI/EHT PLANT <br /> ❑Tti+Rffl PERMITTED FACILITY ❑MOTELA40TEL 13 PUMPER TRUCK�YAItUICHEM TOILETS <br /> D 7XIIEDTATTOEWE PE FACTCING C3 PoOLlSPA 0 LANG USE�t'UCATION SITES <br /> D MEotm WASTE FACILITY <br /> OTHER(PLEASE$PE%;W I . — - - Co 0,10f72 .t/ <br /> WELL AND SEPTIC PERMfT RECORDS ARE.AVAILABLE POR REVIEW - MONDAY-FRIDAY AM-5;OOPM UDINO HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the types) from the 1' a ve bto the y checking the <br /> appropriate box(es). At t one file type MUST be selected. 209 4 3 -{hmflleladd addresses,contact <br /> indicated above. Addr rages will not be accepted--for ass <br /> the EHD.Applications ceived after 3:00 pm wil be pr e e $day <br /> 2. The EHD will notify t applican any E fil i review will be confirmed <br /> approximately ten ( days.of c a Ic I es will be held for a maximum of five business <br /> days for review. int em accordingly. <br /> 3. A file that is active) being on y EHO staff may not be immediately available for review. A new <br /> application may be ub en the file is available. <br /> 4. Any file not return a 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 /> ------------- <br /> 00 v✓�! /.� .Gori � ✓��¢-2 <br /> END 4644 <br /> moos <br />