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Au€". :%1. 2000 3;051 Advaiced GeoEnvironmental No. 5912 P. 1 <br /> DATE RECEIVED _ EMD I.vu NUIv1BER <br /> "-/ SAN JOA'QiJIN COUNTY ._ <br /> r �ENVYRONMENTAL HEALTH DEPARTMIi,NT <br /> 1! t 304 East Weber Avenue,3d Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www,.�igoy.org/ehd <br /> AUG 2 1 2006 <br /> ENVIRQ PUBLIC RECORDS RELEASE APPLICATION <br /> tf:tYhflt <br /> =7nhl T e BUSINESSIAGENCY:+4(AU If�Clt 11) <br /> ADDRESS: S k �a� J�'D �y CA <br /> a <br /> /U(o� PHONE(1): Q .y _1� 1 PHONE(2):A2A- /I2 " 2.A~I�FAC$iM1LE• <br /> C4(led dj, ;c4-1�- TENTATIVE*APPOINTMENT DATE: Time: <br /> "I'ltr 01 (Please allax 10 business days from date of application submittal-*rentative only-must be confirmod) <br /> Snvw f95.a, 9'5.ou <br /> CHECK BOX TO EXPEDITE R((,1LII:ST-Vis==E(C S OR CW-CK ONLY)-REQUEST PROCESSED€N3 BB�J�S,�1,,14ESS DAYS <br /> SIG TUBE OF APPLICANT _DATE C2 1_l�f <br /> UNIT rs18T Z)13UI ION 0 Unit 1 Unit 2 nit nit 4 Unit 5 knit 8 0 Other(sfectovrlicll maps}�� <br /> FILE ADDRESS �. EHO USE ONLY <br /> $treat aStroat Name City <br /> 1. c, <br /> 2. 1 1 5' _T tko -'rH ,Lf Q� i YL-0 <br /> 4. <br /> 7. <br /> s. <br /> Specific Date Range of Information Roquasted:From - to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILESz3(py <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 17 HoimiNG ABATEMENT ❑SWJV WASTE FACILUYNEHICLE da` <br /> OTHER CLEANUP SITE(NON-LOP) IM FOOD FACILITY 0 We.srF TIRE v <br /> UNWRGROUND TANK(MONITORINWREMOVAL) 0 DOG KENNEL C3 DAIRY <br /> HAZAk000 WA$TE GENS WC* ❑CHICKEN RANCH ❑WOBTEWATER?REATMENT PLANT <br /> TJ TIERED PERLGITTED FACILITY D MMLIHOTEL 0 PuNPER TRUCK/YARDICHem TOILETS <br /> G TATTONBODY PIERCING O POOLISPA tJ(LAND USE APPLICATION SITE^ <br /> CI MEDICAL WASTE FACILITY 17 OTHER(PLEASE SFECWy) _ ___ _" _ _ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-$_QOPBII - EXCLUDING HOLIDAY$, <br /> 1. Last up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to209)4464-0130 or mail to the addrew <br /> indicated above. Address ranges Will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications received after 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 WWII be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A filet that Iv actively being worked on by EHD staff may not be immediately available for review. A now <br /> application may be 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 <br /> applicant, future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 1114M. <br />