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May. 18. 2006 9:52PM Advanced GeoEnvironmental No- 4936 P. 2 <br /> DATE RECEIVEDEHO LOG NUM55R <br /> NTALTDEA�E C E 1V ED ENVIRONMENTAL HE HEPRTMENT <br /> MAY 18 2006 304 East Weber Avenue,3'd Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)469-3420 Fax:(209)464-0138 Web:w w.sjgov.org/ehd <br /> ENVIROrVf�1ENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> P <br /> APPLICANT: 60 BUSINESSIAGENCY: c1) ll1 i D <br /> ADDRESS: J god S1`0 CX �� I J <br /> PHONE(9): - (/10 & PHONE(2); A �-__'ZQ - &A�7� FACSIMILE: ab W71-111 <br /> TENTATIVE*APPOINTMENT DATE: -2!j &ft A0& Tlme: /0:0,0 <br /> (Please allow 10 business days from date of appikation submittal-"TenrafPve only-must be confirmed) <br /> CHECK BOX TO EXPEDITE R E T-$83.00 FEE(CA CH K ONLY)-REQUEST PROLE§SED IN 3 BUSIN SS DAYS <br /> SIGNATURE OF APPLICANT _ DATE OWL <br /> UNiT DISTRIf3u N ❑ unit 1 If Unit 2 ❑Unit 3 ❑Unit 4 ❑ Unit S ❑ Unit 5 A Other(electronicllistslmaps) <br /> FILE ADDRESS4. END USE ONLY <br /> Street S Street Name City <br /> 1. Qt / It ! <br /> 2. g L/ U,Les 81alwny /dwf 16161 <br /> (�l <br /> 3l d t I <br /> 5. u ,e r" <br /> Li <br /> S. <br /> C <br /> 8. <br /> 10. <br /> Specific Date Range of.information Requested:From tv <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> IUNDERt3ROUNO TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID ILn <br /> WASTE FACY/1dEHK LE <br /> TNER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑WAsTE TIRE <br /> UNDERGROUND TANK(MONTTORING/REMQVAL) ❑DOG KENNEL ❑DAIRY <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCrJYARD/CHEM TOILETS <br /> ❑TATTOOMDY PIEROING C]POOLISPA LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PEkMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-S:OOPM - F.KCW DING HOLIDAY$. <br /> I. 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 12091464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the END.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five businesa <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by END staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> END 48424)06 <br /> 1M4M <br />