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ob/12/200Y CLHYIUN PLERSFINTON 4 12094640138 NO.975 P001 <br /> 6 6 EHO LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENvmoNwNTAL HEALTij I)EPARTmiNT <br /> 2007 <br /> 304 East Weber Avenue,3"1 Floor, Stockton, CA 95202-270 <br /> TffH elepboixe:(209)468-3420 Fax:(209),464-0138 Web:www_sjgov.orjZdq <br /> _rNV1.R0NM1E,,Wr1 HEA <br /> RVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Zr_erens y W-Ifo" BUSINESS/AGENCY:. 6w'C4 0 <br /> ADDRESS: OW Y-O%t C,944r V,4-wlij 9q_50& <br /> PHONE(1): 9 V;-Li 7-10-2.14 70 PHONE(2): 12-S-Z(60-310? FACSIMILE: 9 2S-If LO- 010 <br /> TENTATIVE*APPOINTMENT DATE: je-ZIO-0f) Time: e r) <br /> (Please allow 10 business days from date of application submittal-*71enratrve only-must be confirmed) <br /> CHECK BOX TO EXPEDn REQUEST-$93,00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION ❑Unit 1 11 Unit 2 11 Unit 3 0 Untt 4 0 UnIt 5 0 Unit 6 0 Other(alectronidlistalmaps.) <br /> FILE ADDRESS EHD USE ONLY <br /> Street of Street Name city <br /> 1. txsT (0 M <br /> 2- 007 <br /> 3. <br /> 4. <br /> S. <br /> G. <br /> 7. <br /> 8. <br /> 10. <br /> Specific Date Range of Information Requested:From Ail to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNWRWWWD TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ARATOMENT INI SOLID WASTE FAcuwAfEHIcLE <br /> OTHER CLEANUP SITE(NON-LOP) D FOOD FACILITY 0 WASTE TIRE <br /> UNDERGROUND TAW(MowromNWREMOVAL) El DOG KENNEL 13 DAIRY <br /> �E HAZARDOUS WASTE GENERATOR M CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT 41111011L a <br /> I� <br /> TIERED PERMITTED FACILITY 0 MoirLIHOTEL 0 PUMPER TRuc)dYARu1CHEm TOILETS <br /> 0 TATTOO/BODY PtEmNa M POOLISPA El I-Amo USE AppucmioN SITES <br /> ❑[MEDICAL WASTE FACUTy 0 OTHER(PLEASE SPECIFY) A41% ASI-, Lt-;-r', tioqnd-L 0_9_L&-�5 <br /> WELL AND SUMC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 3:00 AM-6:00pm - ExcLuDimG HouDAY& <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the N <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)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 review will 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 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. Ul <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the Ak <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review_ <br /> EHD4882-009 <br />