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OCT-23-2007 TUE 03:19 PMC LIERS INTERNATIONAL FAX NO, 2655102 P. 01/01 <br /> EHO LOG NUMBER <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HE ALTIi DEPARTMENT <br /> 600 Easi:Main Street, Stockton,CA 95202-3029 <br /> g3ov <br /> 'or I <br /> I L)6 10 1 - (209)464-0138 Web,www-si <br /> Telephone:(209)468-3420 Fax. <br /> 4 PLICATION <br /> ?CORDS RELEASE AP <br /> PUBLIC M <br /> -AUSINr=SS1ArENcy: <br /> - <br /> APPLICANT: rz-06Y C <br /> ,5�,3 91 6, g, / 't'? 1--.4 0,--0 W e7 <br /> ADDRESS: of 0 Es *,Ox <br /> PHONE PHONE(2): Oa - 0 6?-�1 . FACSIMILE-. <br /> TENTATIVE*APPOINTMENT DATE, IZI,�-lo 7 --Time-.ZP-21-lh <br /> (Pleas®allow 10 business days from—date Oflapil—jeation Submittal-*Tentailve only-Must be confirmed) <br /> IM CHECK 13OX TO EXPEDITE REQUEST-$98.00 FgF-PASHkR CHECK ONLREQUEST PROCESSED IN 3 B $INESS AYS <br /> d/Z 9 <br /> SIGNATURE OF APPLICANT DATE 3 7----7 <br /> Electronic information: El List D MaF,-Description: <br /> FILE ADDRESS city FHD USE ONLY 0 Unit I- <br /> Street Nam a— <br /> rLd <br /> 1. 20 6- Unit 2 <br /> 3. "t5 <br /> .20 3 <br /> Unit 4 <br /> 15 <br /> Ain City <br /> C <br /> L <br /> Unit 34 <br /> Unit 5 <br /> unit 6 <br /> 10. t <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING ABATEMENT 0 SOLID WASTE FACILITYIVEHICI-F <br /> IjER cLEANuP SITE(Non-LOP) 0 F000 FACILITY 0 WASTE TIRE <br /> AUNDERGROUNo TANK(MONITORINGIREMOvAL) 13 Doo KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR M CHICKEN RANCH 13 WASTEWATER TREATMFNT PLANT <br /> 13 TIERED PERMITTED FACILITY C3 MOTFUNOWL rj PumPERTRUCKIYARDICHEM TOILETS <br /> rITATTOOIBODY PIERCING 0 POOLISPA 171 LAND USE APPLICATION$ITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PI-5ASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS A,,iji AVAILABLE FOR RRmEw-MONDAY-FRIDAY 8:00 Am-5:OOPM -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space abOVG- 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(209) 4-013B or Ma ova. Address <br /> F Afi����ss indicatadab <br /> ranges will not bo accepted-for additlanal assistance with-file addresses,contact the MCI,Applications reftIV60 atter <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 recelpt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. be immediately available far review. A now application may be <br /> 3. A file that is actively being worked on kiy EHD staff may not <br /> submitted when the file is available. <br /> 4, Any file not returned In the same condition as released will be reorganized bye <br /> staff at the expense Of the applicant. <br /> Future file reviews by the same appliciint may require a$98.00 deposit prior to review. <br /> END USE ONLY <br /> EMD48-0 WEB 816rAwt <br />