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From:Marcus H. Bole & Asso es 530+633+0119 12-o-'2009 16:12 #140 P.001 <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> s'w , 0 Z 2009 600 East Main Street, Stockton, CA 95202-3029 <br /> ENVIRONMtNT HEALT lephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.o 0 <br /> PERMITISERVICES PUBLIC RECORDS RELEASE APPLICATION 471 <br /> APPLICANT: '. c //11}5: BUSINESS/AGENCY: CztG✓f 4z i�,�,' <br /> ADDRESS: �Y A—yCk !/rim` City/State/Zip <br /> PHONE(1): Sc ✓_0& -e)//7 PHONE(2):, —V4,S — Cb to,� �d FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Z2, h Z /h'_I�'e Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � � „2�lZS�� 5 c DATE _Z2�&y/o <br /> Electronic Information: ❑ List[]Map—Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street# T Street Name City � e_11 Unit 1 <br /> 1. �� ✓�fI _ c? l D u<741_11 D, <br /> SN it <br /> PP <br /> r <br /> /�a 7/. ii \ <br /> 6. 74 Ila <br /> p.. <br /> ❑� Unit 4 <br /> 7. �/ d/asL2i -it <br /> �] Unit 5 <br /> 9. �u /i hE1/!fi i Unit 6 <br /> 10. D - C% ZL) // 06 No('0 1� <br /> Specific Date Range of Information Requested:From to cc\ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE 'A �(`` <br /> t►d OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY E3 WASTE TIRE <br /> (pl tf ERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL 0 DAIRY <br /> ( AZARDOUS WASTE GENERATOR 0 CHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY 13 MOTELIHOTEL 17 PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑TATTOO/BODY PIERCING 0 POOL/SPA 0 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW-MONDAY-FRIDAY 6:00 AM-5:00PM - EXCLUDING HOLIDAYS. <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 <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 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> [ <br /> EHD 48-06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />