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Feb. 17, 2009 10: 37AM Advanced GeoEnvi roni�enal No. 4402 EHD P'__1.vUMEE� <br /> DATE(( ,, <br /> V <br /> COUNTY <br /> LE L�J -- A =J�AQN Ct�CINTY <br /> ENVIRONMENTAL HEALTH M PARTM LENT <br /> FL-'B 17 2009 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: wym%sjgov. <br /> ENVIRONMENT►HEALTH 13 .3 <br /> PERMIT/SERVICEE <br /> S PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 4!tf Cafan _-,BUSINESSIAGENCY: / V4tn4ez 6eaallii/Am& &41 <br /> ADDRESS: W Rd s;tyokka 257-15 <br /> PHONE(1): q�2-(®®Cm PHONE(2): !19'1 - -,3 FACSIMILE: Y(# I f II B <br /> TENTATIVE*APPOINTMENT DATE: S74 +t;K red*ed) Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$9 .0 F (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _- DATE '� �q <br /> Electronic Information: (j List[]Map—Description: <br /> FILE ADDRESS_ _ EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> ✓fart PI Ave ►1At Z <br /> a'v <br /> 3. Ol a- �S Road �YdG .� <br /> 4. <br /> L4 o4e ryut iv as <br /> s <br /> �. t1 <br /> W <br /> 6•_ 1,(/ '1Vunit 4'", <br /> 7, <br /> _ ❑ Unit 5 <br /> 9. _.. ❑ Unit 6 <br /> 1 b.. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNOEROROVND <br /> ...✓✓✓ TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT C3 SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) El FOOD FACILITY C7 WASTE TIRE lam"I I lO(I <br /> UNDERGROUND TANK(MONITORING/REMOVAL 11 DOG KENNEL 13 DAIRY o' 9 <br /> HAZARDOUS WASTE GENERATOR CX, Cl CHICKEN RANCH ASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY E3 MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOOIBODY PIERCING 17 POOL/SPA 0 LAND USE APPLICATION SITES <br /> MEDICAL WA3TE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REyiEW- MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAY$. <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 208 464-0138 or mail to the gddt1ja i 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 /> ANyas released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review, <br /> EHD USE ONLY <br /> • � O f�W- <br /> END 4a.oawse We12007 <br />