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04/09/2010 09:44 9257466099 AEI CONSULTANTS PAGE 01/01 <br /> R;4P;Ur—E0S� SAN JOAQUIN COUNTY <br /> EHD LOG NUMBER <br /> �,I, z010 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> EN\iiRON-MIEN-l" � jdphone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PL IC"IT�Sr ULS <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1 jl BUSINESSIAGENCY: �hEl <br /> ADDRESS: �.56-0 CITY/STATEIZIP: C�/J <br /> PHONE(1): PHONE(2):_ ID 5100- 1 (/o? FACSIMILE: ��' ��(9 <br /> TENTATIV *APPOINTMEN ATE: Time: <br /> (Please allow 10 business days from date of application submittal�`Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115 F SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List Q Map-Description. <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Npme City ❑Unit 1 <br /> 2. N oY-Fil YMGu N slra+ <br /> 3. 22- 40 _N o r+1-1 (y)aAel S-f ree, <br /> 4. 2 NOY �'1'i MCt c ��Q �I Un9t 3 j <br /> s. <br /> 1'2 a EDSf LO kC C4 ftr _ f- Unit4 <br /> 7. 400) Nor+-vi S�±rrru Ind i <br /> 8. p-- IV o,r`l1--i S cM= I. s+. Lo ctA C, < ❑Unit 5 <br /> 9. <br /> Specific Date Range of Information Requestad: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACII_ITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ©WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEL/HOTEL PUMPER TRUCKIYARDICHEMICAL 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-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to telt 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 4 40138 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 Plane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> END 48.0E 8127109 <br />