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'"<uZany 15:06 9165645494 <br /> LEWIS BRISBOIS ET41 <br /> PAGE 02/02 <br /> r <br /> IV DD, EHD LOG NUMBER <br /> I�I;�'� � SAN .IOAgUIN COUNTY <br /> I V E- ENVIRONMENTAL HEALTH DEPARTMENT <br /> U� 9)4 East Main St. Stockton,01 8 Web; <br /> � � Z ZOO�elephon®: (299)468-3420 Fax; (209)464-0138 Web; www.sjgov.orqeO <br /> ENVIRUNftlitf <br /> F�Rhtt� HEAI TN PUBLIC RECORDS RELEASE APPLICATION <br /> ' a----x, <br /> ! <br /> APPLICANT: Lr w s p' Li nIQ 1-'5 BUSINESS/AGENCY: <br /> ADDRESS: 28'50 CTAtGuI YdA!1S 171E at 15p CITY/STATEIZIP: .5Ar—k'A r-jcA/M C g5S3S-- <br /> PHONE(1) 9IG-�O4�-RZI$ PHONE(2)! FACSIMILE: c ��y- 5Y// <br /> TENTATIVE*APPOINTMENT DATE: f11f jO a0ld Tlme: q= j0 <br /> (Please allow 10 business days from data o!apwi ation auammal-•Tad(aft"only•must be wmArmad) <br /> ❑CHECK BOX TO EXPEDITE REQUEST.$11 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN.3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ZZ <br /> Electronic Information- ❑ List L] Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Streets Street Name city Unfit <br /> j34. <br /> Unit 2. <br /> nk3 \ <br /> f <br /> S. � <br /> 8. <br /> 7 Unit 4 <br /> p Unit s <br /> 9. <br /> 70. <br /> ❑Unit e <br /> Specific Data Range of information Requested: From (o 7— <br /> ENVIRONMENTAL HEALTVDEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILQYNEHICLE <br /> ®OTHER CLEANUP SITE((rN�ON•LOP) El FOOD FACILITY 0 WASTE TIRE <br /> ®UNDERGROUND TANK(MONRORINGIREMOYAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDW5 WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELRIOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATT00/BoOY PIERCING ❑PWLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5;00Ptt(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the apace above. Select the type(s)of PIGS from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Eax to(2091404-0130 or mail to the addraes Indicated—above. Address <br /> ranges will not be accepted,for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3AD 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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> END a9E ONLY <br /> END lass <br /> B!2]!a8 <br />