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,99;;e.612008 14:49 FAX 559 442,&081 KLEINFELDER U002/002 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> SEP 2 6 2008 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> ENVIRONMENT HES Wlephone: (209)468-3420 Fax: (209)464-0138 Web: vvwW.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> � <br /> APPLICANT: <br /> 2, <br /> "j- � <br /> BUSINESSIAGENCY: <br /> J <br /> ADDRESS: <br /> PHO E <br /> PHONE(1);. N (2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DAT& Time: <br /> (Please allow ten business days from date of application submittal- rentative only M- <br /> 1 ust be confirmed) <br /> CHECK F30X TO EXPEDITE REQUEST *$98.60�FEII(CASH:OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> Electronic Information: El List El Map- <br /> Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# -Street Namej <br /> city <br /> 17 t elk <br /> _7 , . I .1 11 Unit I <br /> ILIA <br /> M0 I Ajo(01'5�p C]Unit 2 <br /> 6 <br /> 3. <br /> 0(P01 P <br /> 4�p <br /> J�_l 3 <br /> 6. <br /> Will 7T nit 4 <br /> _7 <br /> nit 6 <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> -Z:rU_1DERGROUND TANK(UST)CLEANUP SITE(LOP) ,'n'HOUS(NG ABATEMENT <br /> 2THEIR CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 10 SOLID WASTE FACILITY[VEHICLE <br /> 2NDERGROUND TANK(MONITORING/REMOVAL)CK 13 WASTE TIRE (Oil <br /> G 0 DOG KENNEL DAIRY V Vo <br /> UNDERGROUND <br /> WASTE ENERATOR 0 CHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTEDACIL171 <br /> F 1:1 MOTEL/HOTEL O PUMPER TRUCKfYARD/CHEm TOILETS <br /> CI TATTOO/BODY PIERCING CIPOOUSPA L7 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 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)464-01.3.8 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses, contact the EHD, Application;received after 3:00 pm will <br /> 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 <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 the EHD Staff may not be immediately available for review. A new application <br /> 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 expense of the applicant. <br /> Future file reviews by the same applicant may require a $98.00 deposit prior to review. <br /> EHD USE ONLY <br /> 50 lo 'e <br /> flyM. <br /> EHD 48-06 50I29107 <br /> PUBLIC RECORDS RELEASE APP FORM <br />