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OCT-23-2007 TUE 03:19 I'M CLU.IERS INTERNATIONAL FAX NO, 2#55102 P. 01/01 <br /> F-1-10 LOG NUMBER <br /> DATE RECF-IVED <br /> I--- --i -V <br /> �7-�'� SAN JOAQUIN COUNTY <br /> Al <br /> ENT <br /> I DEPARTMENT <br /> ENWRONME NTALREALT1 <br /> 600 Ease Main Street, Stockton,CA 95202-3029 <br /> c' LoU Telephone: (209)468-3420 Fax:(209)464-0138 Web*WWW <br /> -6ig0v <br /> .or3 <br /> f <br /> PUBLIC RJZ <br /> ?CORDS REL.-ASEAPPLICATION <br /> APPLICANT, USINESSIAGENCY�j <br /> : <br /> ADDRESS: 21P *0d r <br /> PHONE(1)'�2. —PHONE FAcvmit.E: <br /> TENTATIVE*APPOINTMENT DATE, -7 TIM' /LZL'k_ <br /> (Pleas®allow 10 business day,-from date OF'21PPII6k0n submittal-*TenW've Only-must be confirnwd) <br /> C3 CHECK BOX TO EXPEDITE REQUEST-$98.00 ffX-(r-A5H--QR CHECK ONLY)-REQUEST PROCESSED IN 3B $]NESS AYS <br /> 725)� <br /> SIGNATURE OF APPLICANT DATE 3" <br /> Electronic Information: Q List ] Map—Pescription'. <br /> END USE ONLY <br /> FILE ADDRESS <br /> Svoet Namur cityrL0 0 Unit I <br /> 5c, <br /> Lu- Unit 2 <br /> 3. '2,2-0J5 Z- % <br /> /,4)0S/1-7/ Unit 3 <br /> 4. / -- <br /> \Y/ al&nit 4 <br /> '0 <br /> Unit <br /> 5 <br /> unit 5 <br /> 7. u <br /> Unit 6 <br /> 10. <br /> Specific oate Range of Information Ptequeiited:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) rl MOUSING ABATEMENT 10 SOLID WASTE FACILITYIVEHICI-F- <br /> OTHER CLEANUP SITE(NoN-LOP) C3 FOOD FACILITY M WASTE TIRE <br /> )MUNDERGROUND TANK(MONITORINGIREMOVAL) C3 0oa KENNEL 0 DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR M CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY C3 MoTFUNOML Cl PUMPER TpjjcK1YARDICHEm TOILETS <br /> r1TATT001BODY PIERCING 0 POOLISPA 173 LAND USE APPLICATION$rrrms <br /> E3 MEDICAL WASTE FACILITY 0 OYHFR(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS AIlr AVAILABLE FOR RWAFW-MONDAY-FRIDAY 8;00 AM-5:09PIA -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the Space above. Meet 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(2091,.404!0138 or mail to the address sLd <br /> _j,dIc" above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD.Applications rocelveU atter <br /> 3:00 pm will be processed the next business day. <br /> 2, The EHD will notify the applicant The <br /> 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. be immediately available far review. Anew application may be <br /> 1 A file that is actively being worked on by 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 by EHD 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 /> EHD USF ONLY <br /> END 4M6 WEB 8WOU1 <br />