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9 <br />Nov 13 08 01:19p S ra Delta Corp p.1 <br />EMB LOG NUMBER <br />�,�'���L'-��j� SAN ENVIRONMENTAL <br />COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />NOV 2008 600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Pax: (209) 464-0138 Web: www.sjgov.org/ehd <br />ENVIRONN EN i HEALTH <br />PERkIff/SERVICES , PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT:. U41E jg"4114,KLI BUSINESS/AGENCY: nt:g4!& GE�Ts CnRfbRl+Tic�s � <br />ADDRESS: 5MO- 0, 5IYr11 STT 15. City/state/mp3✓��hQ i Ln. 411-110 — <br />PHONE (1): 65-'s z -_1411 _ _ PHONE (2): FACSIMILE: 554-1) ZZ:2 <br />TENTATIVE" APPOINTMENT DATE: t i 1$'U _ Ti.. 4= -=—wt �iO <br />(Please allow 10 business days from date of Application submittal - "Tentatttre only - must be confirmed) <br />a CHECK BOX TO EXPEDITE REQUEST - $106 FEE (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE C1 I IMIOff' <br />Electronic Information: [j List ❑ Map — Description: <br />FILE ADDRESS EHD USE ONLY <br />Street tt <br />Street Name <br />® Unit 1 <br />City IP <br />STOLC7'bP4 (� ❑ Unit 2 <br />unit 3 <br />lop <br />Unit 4 <br />❑ unit 6 <br />❑ Unit 5 <br />F2. <br />4vR.T.�2t-00 rioA6 <br />3. <br />4. <br />5° <br />6. <br />7. <br />8. <br />9. <br />10. <br />Specific Date Range of Information Requested: From ;2004 to pggstyAT <br />(ENVIRONMENTAL HEALTH DEPARTMENT FILES/ <br />M UNDERGROUND TANK (UST) CLEANUP SITE (LOP) D HOuvrio AoATEMENT D SOLiD WA37E FACI1 W/VENICLE � <br />IM OTHER CLEANUP SrW (NON -LOP) ❑ FOOD FACILITY 0 WASTE TIRE ` <br />® UNDERGROUND TANK(MONrroRING/REMOVAL)VrC M DOG KENNEL 0 DAIRY <br />M HAZARDOUS WASTEGENERATOPO/ D CHICKEN RANCH D WASTEWATER TREATMENTPtANT <br />D 7nEREo PERAiITTED FACILITY ❑ Mo-mL/HOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br />0 TATTOO/BODYPIERCING D POOLISPA Cl LANoUSEAPPLICATION SITFS <br />Cl MEDICAL WASTE FACILITY CI OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILASLE FOR REy1Ew - MONDAYFmoAY $:00 AM-6:00PM -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 (2091464-0138 or mail to ft. Ajddreas Indicated 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 EMD 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 />EH0 USE ONLY <br />