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Jul. 13. 2006 2:53PM Aced GeoEnvi ronmental No. 5480. 1 <br /> DATE KtC:Elvtu 9 =Hp Zv"��UUi3ER <br /> SAN.70AQI.iIN COUNTY <br /> ENVIRONMENTAL HEALTH.DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor; Stockton* ,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:w-ww.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION � <br /> APPLICANT: V Zan o BUSINESSIAGENCY: 1�f�MGA <br /> ADDRESS: S a 551-0C1 I S <br /> PHONE(1): `�6 - 7 1 —1,00& PHONE(2)):(9 D 1;` '! tf FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: t T � �`t O(®Q 60 Tithe: " <br /> (Please allow 10 business days from date of application submittal-'Tentadvn only,-must be confirened) (= ("�fi <br /> CHECK BOX TO EXPEDITER T-X93.00 F( (C OR C ECK ONLY)-f2sQUSST PROCESSED IN B INESS DAYS <br /> SIO TURE OF APPLICANT DATE / A <br /> UNIT DISTRIBUTION ® Unit 1 IfUnft 2 O Unit 3 13 Unit 4 ❑Unit 5 0 Unit 6 0 Other(efea mnleAlsts/map4) <br /> T=ILE ADDRESS EHD USI ONLY <br /> street ti Street Name <br /> 1. to* <br /> 2, to ►' tt- to <br /> 3. /1 it t /� <br /> 4. t) Ribon <br /> 6. e <br /> 6. S► U <br /> 7. L C <br /> It it <br /> 10. %) U'� l <br /> pecific DatA Range of Infoena(;ion 6tegUeated:From DC) to <br /> . ntr-rw Dr,Lt ENVIRONMENTAL HEALTH DEPARTMENT FILES � <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOF) ❑HOUSING ABATEMENT 13 SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) E3 FOOD FACILITY @ WASTE TIRE <br /> NDERGROUND TAKK(MONITORINGIREMOVAL) A DOG KENNEL Q DAIRY <br /> HAZARbous WASTE 06NARATOR ❑QWKEN RANCH 13 WAS*TEWA"R TREATMErtr PLANT <br /> t]TIERED PSRMMO FACILITY 13 MOTELMoTEL 0 PuvPER rRucwYARD1CHEM TOILETS <br /> ❑TATTOOMODY PIERCING ❑POOLISPA VLAXV USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORD£ARE AVAILABLE FOR MM- MONDAY-FRIDAY 8:00 AM-S:QQPM - 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 <br /> appropriate box(es). At least one flie type MUST be selected. Fax to(2081464-0138 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 neva <br /> application day be submitted when the file is available. <br /> 4. Any file not returned in the sante 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 /> ,.fry <br /> EHO 4042.006 <br /> W114W <br />