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ltTE RECEIVED - tHU LU(3 NUMUtK <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART T <br /> a <br /> '.r L;-' U 600 East Main St. Stockton, CA 95202-30 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: v*brg/eh <br /> i <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESS/AGENCY: 1= C n=1 9 <br /> ADDRESS: 352 LJ.e. , c+c Z 0 0 CITY/STATE/ZIP: k Meso, <br /> PHONE(1): 6'1,0- (D - 3 PHONE(2): �5 I 0-0'S_-65,2(2' FACSIMILE:'51 Q-295 - 2657(0 <br /> TENTATIVE"APPOINTMENT DATE: -Lola Time: <br /> (Please allow 10 business days from date of applicatlo submitta 'Te tative only-must be confirmed) <br /> CHECK BOX TO EXPEDIT QUE -$115 FEC5tASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUINESS AYS <br /> SIG TURE OF APPLICA DATE <br /> Electronic Information: 9.List ap- cript n: i rOvwvNe = Lppq <br /> FILE ADDEHD USE Olty <br /> Street# Street Name City <br /> Unit 1 <br /> 1. Z3O � ✓1dc�Sh'i� v2 <br /> Cy I <br /> 2. b _-�n_Y 3�1 "kmac)/l �(� A_ 1 4 Unit 2 <br /> 3. Cj <br /> 4. ( Q Ck VF— t f 5` Unit 3 <br /> ;. <br /> 6. 2 W Nta l r) S r f Unita <br /> 7. QQ <br /> 8. 2Z-7� � � 7 _1, ❑Units <br /> 9. -j 3 I V_\ -- <br /> unit s <br /> Specific Date Range of Information Requested- From to <br /> ENVIRONMENTAL ALTH DEPARTMENT FILES �7 <br /> ,UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITYIVEHICLE <br /> 9NDERGROUND <br /> THER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ElWASTE TIRE <br /> TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL MPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑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:OOPM(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 least 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$115 deposit prior to review. <br /> 5. If you need further assistance, please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> EHD 48-06 <br /> 8127/09 <br />