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C <br />07/02/2008 11:57 2133800P"5 ENVIRONMENTAL PAGE 01/01 <br />40 <br />1]ATE- f G€)1/Epr ;-- EHD LOG NUMBER <br />SAN JOA.QUIN COUNTY <br />ENVIRONMEN'T'AL REAL'H DEPARTME�V7c <br />ei E'0 i 304 East Weber Avenue, 3rd door, Stockton, CA 95202-2708 <br />``++ t} <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wwtivsjgav_ r / <br />"50Y <br />� �s i, 11 . 1, .psi _i!� ! HEAL11 <br />PHONE (2): v _FACSIMILE: 2, l 3"�)BU --0,50 <br />TENTATIVE" APPOINTMENT DATE: Time: <br />(Please allow 10 business days from data of application submittal - *ronta&e only - must De confirmee) <br />CHECK BOX TO EXPEDITE RSQu ST - $ C H R CHECK ONLY - REQUEST PROCESSED IN 3 BUSINESS DAY$ <br />4-77 <br />SIGNATURE OF APPLICANT f ,��- t �, ) DATE + �M(CA <br />Electronic Informatlon: ❑ List ❑ Map — Description; <br />Specific Date Range of Information Requested: From __ to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES i 1 f�,kv <br />UNDERGROUND TANK (LIST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE "1 {' <br />OTHER CLEANUP SITE (NON -LOP) E7 FOOD FACILITY WASTE TIRI! <br />UNDERGROUND TANK (MONITORINWREMOVALYI d DOG KENNEL DAIRY <br />HAZARDOUS WASTE GENERATOR ® CHICKEN RANCH (J WASTEWATER TREATMENT PLANT <br />TIERED PERMITTED FACILITY Q MOTELIHOTEL d PUMPER TRUCK/YARD/CHEM TOILETS <br />TATTOO/BODY PIERCING Q POOLISPA 13 LAND USE APPUCATION SITES <br />Q MEDICAL WASTE FACILITY 0 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM-S:OOPM - EXOLUDING HOWDAYS. <br />1. List up to ben addresses in the space above. Select the types) of files from the list above by checking the appropriate <br />box(ee). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicate 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 tiles 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 $96.00 deposit prior to review- <br />EHD U$E ONLY <br />