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04/24/2007 08:56 5302445021 LAWRENCE ASSOCIA PAGE 01 <br /> DATE REGENED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH I)FPARTMFNT <br /> 600 E. Main Street, Stockton, CA 95202-3029 010?Q <br /> jgov.or]38 Web:wTelephone; if <br /> 3U <br /> PUBLIC RECORDS RELEASE APPLICATION ` <br /> APPLICANT: USINES AGENCY; ( ( W rISt// 4- i�S5—QtLO e$ <br /> ADDRESS:_'2-OO _ t 01 <br /> PHONE(tI: S,O-Z`l`('-a70 � PHONE(2): SIMILE; S�iO^Z-tfY-Sa7_J <br /> TENTATIVE'APPOINTMENT DATE: S e: 7 DQE 14•h t 2-fA <br /> (Please allow 10 business days from data of appl cotton b e my must he conflrmelQ <br /> CHECK BOX TO EXPEDITE REQ ST-$9S." CASH O +� } -REQUEST PROCESSED IN 3 BUSINESS DAYS 1_—JaACJ01 G. <br /> SIGNATURE OF APPLICANT +� DATE <br /> Electronic Information: ❑ Lis Map-Desc(iption: <br /> FILE ADDRESS EHD USE ONLY <br /> Street IF � ►street Name City ❑ Unit t <br /> 1. f D q aS_� N. F, F' { \ <br /> 2. <br /> 10 ?t{2 n I 1 �unh z <br /> 3• 1105-00 <br /> `• J� Unit 3 <br /> 4. <br /> 5, �I?z / Unit 4 <br /> 6. <br /> T. ti r " ❑ units <br /> 9. _ unite <br /> 10. 10 .A o 1 o. ulna t -SCIG�GSG <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �UNOBRGROUND TANK(USTI CLEANUP SITE(LOP) 11 HOUSING ABATEMENT r�r SOLID WASTE FACILIT9NEHICLE <br /> OmiM CLEANUP SDE(NON-LOP) C3 FOOD FACILBY rWASTETRE <br /> �UNOEROROUND TANK(MONITORINOIREMOYAL) 13 DDG KENNET. 'a-DNRY <br /> HAZARDOUS WASTE GENERATOR ❑CNICI EM RANCH O'WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0MOTELTHOTEL 0 PUMPER TRUCKrYARDICHEM TOILETS <br /> O TATTODIBDDY PiMaNc O POOLISPA LAND SE,(p',PPUCATTON SITES <br /> ❑MEDICAL WASTE FACILITY Z OTHER(PLEASE SPECIFY) � I TZ <br /> 'I^'S" <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 1:00 AMS:DOPM - E%CLUDINO 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 least acre 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 ba raorganized by EHD staff at the expense of the applicant. <br /> Future fila reviews by the same applicant may require a$9S-00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 4l OE WtX2 won <br />