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10/31 05 1 49 9219343665 ARCHER WALNUT CREEK PAGE 02/02 <br /> n�V/l l; NUMBER <br /> SAN JO,A,QUD;COUNTY J1 <br /> 5 ENVIRONMENTAL HEALTH DE PARTNEENT <br /> 304.>✓ast Weber Avcnue, 3rd Floor, Stockton,CA 95202-2708 R061q <br /> EW1RONf`�!ENT NEA%T 1-i Telephone.(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> pFp,\,1-1 'SEG; /ICES <br /> UBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; Auto7-one c/o Archer Norris - <br /> � BUSINESS/AGENCY: <br /> ADDREss; 2033 North Main Street, Suite 800, Walnut Creek, CA 94596 <br /> PHONE(t): 925-93,0-6600 PHONE(2): FACSIMILE: 925-930-6620 <br /> TENTATIVE OINTMENT DATE: NIA Time: <br /> (Please allow 0 business dQya from date of application submittal-`renht ive only-must be confirmed) <br /> L7 CHECK BOX TO EXPEI RTE T-$93.00 FEE(CASH Oil CHECK ONLY)-REQUEST PROCESSED IN 3 13SIN DAYS <br /> SIGNATURE OF APPLICA REQU ohm Kortum, Esq. DATE d ri <br /> UNIT DISTR18UTION unit i V d un unhwWnIt 4 M Unit 6 O Unit 6 ❑ Other(electronIcAlsts/maps) <br /> FILE ADDRESS EHD USE ONLY <br /> 0 Street Name City <br /> 1• 1100 North ilson Way toc on <br /> 2 West 1 th Street racy - <br /> 3- 09.. �t er Lane Stockton <br /> 4, 7 in_�tr t Manteca - \ <br /> eman Lodi X <br /> 6, Sutter street Stoe tou <br /> 7- 2 West Lane toe ctou <br /> 8- - ort ,1 Dorado Stockton <br /> Specific Date Range of Information Requested:From January Z000 to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEA UP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE PACILITYII/EHICLE <br /> X10n{ER CLEANUP SITE(NON-LOP) ❑FOOD FACILnY ❑WASTE TIRE <br /> d UNDERGROUND TANK(MONMORIN /REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> 2M HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH t3 WASTEWATER TREATMENT PLANT <br /> 'MTIERrED PERaaITTED FACILITY ❑MOTFI.IHOTEL O PUMPER 11iUCKIYARDICHEM TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOUSPA 0 LAND Usc APPLICATION SITE$ <br /> r�MEDICAL WASTE FACIULTY Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERM T RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-6:1)OPM - ExcLU01No HOLIDAYS. <br /> I. List up to ten addresses n the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At I ast one file type MUST be selected. Fax to(2091464-0138 or mall to the address <br /> indicated above. Addrranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHD.Appllcations elved after 3:00 pm will be processed tate next business day. <br /> 2, The EHD will notify theapplicant if any EHD 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. Appoin ents should be scheduled accordingly. <br /> 3. A file that is actively bein 3 worked on by EHD staff may not be immediately available for review. A new <br /> application may be subm tted when the file is available. <br /> 4. Any file not returned In tt a same condition as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future file rev ews by the same applicant may require a$93.00 deposit prior to review, <br /> 77 <br /> •S` <br /> EHD 4449-M <br /> IfUMS <br />