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11/30/2009 11 :54 FAX 2002/002 <br /> �H LOG NUMBER <br /> 'V SAN JOAQUIN COUNTY <br /> NOV 3 02009 ENVIRONMENTAL HEALTH DEPARTMENT. ,- <br /> 600 East Maln St.Stockton, CA 95202-3��3j� <br /> ENVS�j R� <br /> Pone; (209)468-3420 Fax: (209)464-0138 Web:www,sfgov.org <br /> PERM i `� 7 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:�� <br /> �k ] , - BUSINESS/AGENCY: --\I kM5, �- <br /> ADDRESS: 14"'>L� hjW= 4l A,�,rE- car[T C- CI'TYISTATErziP: TM2-1 <br /> PHONE(9): PHONE(2): 6 t'��9 LM -28 FACSIMILE: l(. 4$0—0 6 a3 <br /> rENTATlyE"APPOINTMENT DATE: 1y3/139 _ Time: OF$oD <br /> (Please allow 10 business days from data of application submittal-•Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REO - 75 (CA OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN DATE <br /> Electronic Information: ❑Lis Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name City 0 Unit 1 <br /> S`{f tarp �� �.-}f. .- '..�•- � _. <br /> 2.- S L-1A 1]Unit 2 <br /> 3. S ?er 1AJ. LAhLrAtz0 Tare .Cv <br /> a. L--I <br />' �• 2'��S 4�YD -T�c. /Z' <br /> 7. <br /> Unit 5 <br /> 9. <br /> 1 O. <br /> 0 Unit 8 <br /> Specific Data Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ANDERGROUND TANK(LIST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOUD WASTE FACILITYNEHICLE <br /> ftiER CLEANUP SITE(NON-IAP) []FOOD FACILITY ❑WASTE TIRE <br /> �DERGROUNII TANK(MONn-ORINGIR>wMOYAL) ElDOG.KENNEL ❑DAIRY <br /> [�'t1AIARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEI ❑PUMPER TRUCKIYARpJCHEAICAL TOILETS <br /> ETS <br /> ❑TATTOOIBODY PIERCUWG ❑POp11Sm ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW.- MONDAY+FRIDAY B-00 AM-5:00PM EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the h"&)of files from the list above by checking the appropristo <br /> box(et:). At least one file type►OUST be selected. Fax 1412091464-0138 or mail to the address IndloR"� ve• 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 END will notify the applicant if any END files exist. An appointment for review will be confirmed approximately ten(iii) <br /> days after receipt of application. The flies 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 END staff may not he immediately avallable for review. A new application may be <br /> submitted when the file Is avaiiable. <br /> 4. Any file not returned in the some condition as released Will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$116 deposit prior'to'review. <br /> S. If you need further assistance,please contact Diene Martinez,at(209)468-2425. <br /> END USE ONLY <br /> EHD 48-06 6127109 <br />