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SEP-21-1996 21.'23 -` P.02/02 °• <br /> U <br /> 4 E}}D LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUN'CY <br /> - <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 60011. Main Street, Stockton, CA 95242-302930 <br /> Telcph4ne: (209)46$-3420 Fax. {209)46A-013$Wein: www.sjliv.DrglChd . <br /> t: <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> - ---. .. 13U31NE;&SlAGENCY: <br /> APPLICANT: ~ <br /> 'Zoos r r �r SL <br /> ADDRESS: - <br /> PHONE PHONE(2): - FACSIMILE: i <br /> TENTATIVE"APPOINTMENT DATE: <br /> Time: ID=bG }foul <br /> (Please allow 14 business days from date of application submfttal-'rentative only-must be conflrmod) <br /> CHECK aOX TO(XPEDITE REQUEST-$96.00 FEE(CASH OR CHECK ONLY).REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE lJ�o� .. <br /> Electronic Information: ❑ List❑Map—Description: <br /> FjLE AC)DRESS END USE ONLY <br /> Street of Strse(t Nama _ City _ ❑ Unit 1 <br /> 1. �3 T� �d.le,ro-ccl ❑ UnIt2 <br /> 3. Unit 3 � <br /> 4. <br /> 5. — It; <br /> 6. <br /> 7. D Unit 6 <br /> 9. - ❑ Unitt; <br /> Specific nate Range of Information Requested:From �14°iS� to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> E UNDERGROUND TANK(U-5T]CLEANUP SITE(LOP) 0 11"MG ABATEMENT ©SOLID�1ASTE FACILlTY1YENICLE <br /> OTHER CLEANUP SITE(NoN-LOP) t7 FOon FACILITY Q WASTE VIRE <br /> M PERGROUNU'TANK(MQNITORINGIREMOVAL) 0 Dao KENNEL 0 DAIRY <br /> AZARDQU9 WASTE GENERATOR 13 CHICKEN RANCH 0 WASTEWATER TREATMN NT PLANT <br /> fa TIERED PERMITTEo FACILITY CJ MOTEL tJOTEL P PUMPER TRUCKIYARo1GHFM TOILET$ <br /> d TATTOOIBODY PI€RCING ❑POOLISPA 0 LAND USE APPLICATION$ETES <br /> 13 MEDICAL WASTE FACILITY CI OTHER(PLEASE SPECIFY) <br /> WELL AND SFPrnG PCRMIT RECORDS ARF AVAILABLE FOR REVIEW - MONnAY-FRIDAY 5:w AM-5;OOPM - EXCLUPING ROUDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by cheeking'the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209 4G4-013§or mall jo the addlg5s 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 /> ro EH0 files exist. An ointment for review will be confirmed approximately ten(10) <br /> 2. The EHD will notify the applicant if any appointment <br /> after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> days a r Tac pA <br /> Y I <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHQ 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 EEO staff at the expense of the applicant, <br /> Future file reviews by the same applicant may require a$96.00 depbsit.priorto review, <br /> EHD USE ONLY <br /> EK0 0-00 911312006 WO <br /> i <br /> TOTRL P.02 <br />