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62/08/2686 15:52 91GG439r:4r, TETRA TECH MCCLEl., A,N <br /> PAGE 61/61 <br /> DATE RI=CEiVED allD LOG NUMSER <br /> SAN JOAQUIN COUNTY <br /> �p S <br /> It <br /> +v WMONMENTAL.JEALTH DEPARTMENT i <br /> It!II +1' EL LQJ 304 East Weber Avenue, Yd_Flaor, Stockton,CA,95202-2708 <br /> Telephone:*(209)468-3420 Fax:(209)464-0138 Web:www,sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> pm;,tfusm 13USINESSlAGENCY: <br /> ADORESS:` ! r✓F !D/ <br /> PHONE(1): ."11b, / PHONE(2): T PACSiMiLE: <br /> TENTATIVE"APPOINTMENT DATE. Z22-06 -Time: /d:b4,0­� <br /> (Please alloy 1D businessdays frOM date Of applicatloo submittal-'Tent bye only-must be confirmed) <br /> 0 CHE(:I(BOX TO EXPE:DITE'REQUEST-$9 a FEE(CAS CHECK ONLY)-REQUEST PPOCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> UNI'DISTRI81 Tf ON © Unit 1 D Unit 2 E3 Unit 3 ❑Unit.4 ❑ Unit 5 D Unit 6 O Other(e(ectronic/iirWmaps) <br /> - FILE ADDRESSEIiD USE ONLY <br /> Street# Street Name city <br /> 4. <br /> 7. <br /> N <br /> Specific Date.Range of Information Requested:Froin to ! <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> iINDEItGRpulva TANK(UST)CLEANUP SITE(LOP) ©Hovsm ABATEMENT )a smmwAsm FAcLLITYNEIi ma <br /> OTN£R C.EAVUP Sr E(NON-LOP) ❑Fom FACILITY D WASTE TIRE <br /> UxaeRoRourioTANK(NIvwmRiNe/RemdvnL) D DOC KERNEL D DwRY <br /> i HAZARDOUS YJA t7t GENERATOR 13 CmicKEN RANCH 21 wASTEwATER TREATMENT PLANT <br /> TIERED Prmmf mu FAcwrr ❑MOTUMPTEL ❑PUMPER TRUC9/YARDICHEM TOILETS <br /> D TATMWBO0 V PIERCING 0 POOLISPA 0:EJWb Use APIRJCATiON Sn" <br /> LI MEDICAL WASTE FACILITY 13 OTHER(PLEASE'SPECIFY) __-- <br /> _rf'ai.k AND SEPTic PERMIT RECORDS ARE AYAILABL£FOR REYIEw •.MONDAY-FRIDAY 8:00 AEI,:GtYPM -EXCLU m HoLIDIAYS. <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 file type MUST be selected. Fax to(Z091 464-0138 or mall Lo th address <br /> Indicated above._ Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHO. 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 /> approXirl--ately ten (10)days after receipt of application. The files will be held for a maximum of flee 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 new• 'I <br /> application may be submitted when the file is available. . <br /> 4. Any file not returned in the sate. 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 revlew. <br /> 1l1RrgS y <br />