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DATE RECEIVED EHU LUG NUM13LK <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMERT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd� <br /> 1 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: <:zdA / 4o �7 BUSINESSM&ENC'r: ZVWAruEnlCA <br /> ADDRESS: II 2L/✓I IY7— / - .3 .c � l '75266-3 <br /> PHONE(1 y. 320—2429 PHONE(2): 131)•-��J FACSIMILE: <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 REQUEST-$95.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street N e City ❑ Unit 1 <br /> 1• LLC /ST <br /> 2. 6f <br /> El <br /> 2 <br /> 3. Unit 3 <br /> 4. Fae. FO.Q Q .t(.4SC Ccli% SSF�/�/ <br /> 5• &-s s LE O <br /> Urif}�4 ; <br /> 6• Co S --1 Sn is <br /> T• 02.. 5 3 ❑ Unit 5 <br /> 8 /SOS— <br /> ❑ Unit 6 <br /> 1 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH D16PARTMENT FILES <br /> l7 ynDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 13 SOLID WASTE FACILITYIVEHICLE <br /> orri" <br /> CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY 13 WASTE TIRE - <br /> Iff UNDERGROUND TANK(MONiToRINWREMOVAL) 13 DOG KENNEL 13 DAIRY <br /> EYfUSARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTOOIBODY PIERCING 13 POOLISPA E3 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY O OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:0OPM - 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 appropriate <br /> box(es). At(east one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 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 approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> 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 application may be <br /> 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 applicant. <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review.,. <br /> EHD USE ONLY <br /> EHD 4846 9/132006 <br />