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RECEWD'­A EHU LOU NUM15LK <br /> E . <br /> SAN JOAQUIN COUNTY <br /> T A <br /> ENVIRONMENTAL <br /> k' 1 <br /> HEALTH DEPART <br /> 600 East Main St. Stockton, <br /> J' <br /> A 95202-3 <br /> _ , ,jelephone: (209) 468-3420 Fax: (209) 464-0138 Web.: rg/eh <br /> F <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1-4t)tt BUSINESSIAGENCY:_�—_ 9 Z(C'z 61 <br /> 3'___Z M(O4 ZOO CITYISTATE/ZIP: <br /> ADDRESS: n---;) <br /> PHONE(1): 1- - '39 PHONE (2)-. �_51 o-(o?IS--(�2(c?' FACSIMILE-.'510-29 5 2 6 5_(q <br /> TENTATIVE*APPOINTMENT DATE: 'z_oiQ Time:. ZA,,v- <br /> (Please allow 10 business days from date R appt1CatI9n`submIttaU`Te dt&dVe only-must be confirmed) <br /> CHECK BOX TO EXPEDaIT : 07U -$115 F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU�INE SS PAYS <br /> ' <br /> SATURE OF APPLICA DATE- <br /> Electronic Infonnation: El LIstP9MaP7-b"Criptkn- iW 777 -77 9,,'eor) <br /> FILE ADDRESS EHD USE 0 Y <br /> Street# Street Name city <br /> Unit I <br /> w-y <br /> 3 LA_ 1 Y""� � D <br /> 2. Unit 2 <br /> Y-) <br /> 4. C) tkUnit 3 <br /> 1A 4 <br /> S . <S ,1-c)c +-oy-\ Ave5. 3- '3,U <br /> 6. 21 kA&:tf_) �4j IdUnit 4 <br /> 7. 111 \/0 Ira <br /> . <br /> 8. 2 2--7 CO) t+W�4 99 -3 5-A-Al 0 Unit 5 <br /> 9. <br /> •rid <74- <br /> 10. 'q, Unit6 <br /> Specific Date Range of Information Requested: From Q it e to <br /> ENVIRONMENTALALTH DEPARTMENT FILES <br /> OTHER <br /> TANK(UST)CLEANUP SITE(LOP) Ej HOUSING ABATEMENT SISOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NOW LOP) El FOOD FACILITY El WASTE TIRE <br /> _ NDFRGROUND TANK(MONITORINGIRF-movAL) El DOG KENNEL []DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH -JaVASTEWATER TREATMENT PLANT <br /> T <br /> �F <br /> wAT-rooWDY PIERCING El POOLISPA IERED PERMITTED FACILITY ❑MOTELIHOTEL I!rPVMPER TRUCKIYARDICHEMICAL TOILETS <br /> [:1 -1 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY Ej OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT REcORDS ARE AVAILABLE FOR REVIEW: -FRIDAY 8:00 Am-5:00pm(EXCLUDING HOLIDAYS) <br /> I <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> bok(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the address 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 EHD 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$115 depoift prior to review. <br /> S. If you need further assistance, please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY, <br /> EHD 48-00 8127109 <br />