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2006 9:52PM Ad--c ed GeoEnvironmental No. 4936 P. 2 <br /> !`CEIVED SAN JoAQYJIN COUNTY <br /> EHD LOG NUf�13Ef2 <br /> D.46"C f D u Iv E D ENVIRONMENTAL HEALTH DEPARTME^7T <br /> 304 East Weber Avenue,3rd Floor, Stockton, CA 95202-2108 <br /> FLAY c00b Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjzov.org/ehd <br /> L3 "? Iq <br /> EDIRON /-qF HEE__2 PUBLIC RECORDS MLEA.SE APPLICATION <br /> APPLICANT: U ta n 6 n BUSINESSIAGENCY: �G�Q._ <br /> ADDRESS: ' J 8 Q S� m�y �7 �-y�) � I s a <br /> PHONE(1); 1:20 - 07-140,9& PHONE.(2): �^^���,��7,, --- !�� "`tRA / ZS FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: c2!II L� Z6 Time: 10:nq 10 <br /> (Please allow 10 business days from date of app! tion submktal-*Tentative only-must be conermod) <br /> CHECK BOX TO EXPEDITE UE T-$89.00 FEE(CA CH K ONLY)•REQUEST PROCEEiSED IN 3 BUSIN SS DAYS <br /> SIGNATURE OF APPLICANT _ DATE —� JJV <br /> UNIT DISTRIBUTION O unit i Ef Unit 2 O Unit 3 ❑ Unit 4 ❑ Unit S Q Unit 5 A Other(electronicllist imaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Strast u Street Name city <br /> 2. <br /> 3, <br /> 4. -sloweS PIMVl4 G 2 <br /> �5. u e C' U <br /> 6, <br /> ..7. 2 <br /> 6. rn1 <br /> s. _ <br /> w Eta- <br /> 10. 1 <br /> Specific Date Range of.lnformatfon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILE$ <br /> fHA,UACI <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WA&TE FLiTYMEHICLE <br /> THEIR CLEANUP$ITE(NON-LOP) m FooDFACILITY 11 WAST E TIRE <br /> UNDERGROUND TANK(MONITORINu1REMOVAL) El DOG KENNEL ❑ DAIRY <br /> z.ARwus V'IASTE GENERATOR ❑ CHICKEN RANCH O VYA�TEVVATER TREATMENT PLANT <br /> G Tl£RED PERMITTED FACILITY ❑MOTEL/HOTEL ❑ PUMPER TRUCN'JYARDICHEm TOILETS <br /> C TAYTWBOOY PICRGNG 0 POOL/SPA ALAND USE APPLICATION SITES <br /> CI MEDICAL WASTE FACILITY C OTHER(PLEASE SPECIFY) _ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REview- MONDAY-FRIDAY 8:00 AM-5;OOPM - EXCLUDING HOLIDAY$. <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to f209)464-0138 or mail to the address <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 ravlew will be contirmod <br /> approximately ten(10)days after receipt of application. The tiles will behold for a maximum of five bus'rw* <br /> days for review. Appointments 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 <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 expenaa of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EHD M-02-M <br /> 1!14(05 <br />