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Downey Brand LLP 4/20/2010 8 :59 PAGE 002/002 F x Server <br /> DATE RECEIVED E DL G NUMBER <br /> APR 2 0 2010 SAN JOAQUIN COUNTY % �y <br /> ENVIRONMENTAL HEALTH DEPARTMENT 5, 05(/ <br /> ENH 600 29 <br /> PE iSERVI�ES Telephone: (209)468-34st 20 Faxain : Stockton, 3 <br /> (209)464-0 38 Web:I� PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; �,-,.p 1 <br /> I Q '�L �'tnr.Q.2.12 f BUSINESS/AGENCY: <br /> ADDRESS: (�a l ern T O 11 la d t Fit'. CITY/STATE/ZIP: e_ O C A 95F5tDy <br /> PHONE(1): PHONE(2):!6Q7rI{0ea— 14'71 FACSIMILE: 91(9- 50-1�)0 (' <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 REQUE -$115 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> J-4SIGNATURE OF APPLICANT D�9 DATE 19 ,10 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> _ FILE ADDRESS END USE ONLY <br /> Street R Street Name City ❑Unit 1 <br /> 1. 113 l�l'�"L�Y1_ 1�1f'oY_1 az9l�.l.� <br /> 2. <br /> ❑Unit 2 <br /> 3. <br /> 4. <br /> Unit 3 / <br /> 5. �U <br /> IN <br /> 8' .in Unit 4 <br /> s. <br /> ❑Unit 5 <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From I to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILRYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(UomTORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICALWASTE FACILITY 2OTHER(PLEASE SPECIFY) : 2'n5pt +. of>5(&r VirOf1rY_,nt0Lj)Land <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00Pfn(EXCLUDING HOLIDAYS) PD,f Mit <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 d OC,umil-4 <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 END. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END 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 END 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 END 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 /> ENO USE ONLY <br /> MD 4846 <br /> anion <br />