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FAIR RECEIVED 41EHD LUG NUMBER <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT q <br />600 East Main Street, Stockton, CA 95202-2708 <br />I �QQ� Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: Nvww.sjgov.org/eh <br />IyyfEi lf't.si::i'i 7Lr;i.r <br />� ���i f/;, 4;�/i <br />PUBLIC RECORDS RELEASE APPLICATION s� <br />APPLICANT: yNV > "( t�i's�C1� B�U`SINESS//A�GENCY:LI�7NC -2 1. ?�VCN <br />ADDRESS: C'� V� ��i� �� 2 8 s{ l^7V*5-52:L'3; <br />G �Iy . Com'+ 9 q L G9 <br />PHONE (1): 4 L a—Q 5 �$ PHONE (2): "1-- ` J -32 L 3 FACSIMILE: <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITEUEST - $9 00 F C H OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSIN SS DAYS <br />SIGNATURE OF APPLICANT DATE 21 O 6 , <br />Electronic Information: ❑ List ap — Description. <br />FILE ADDRESS <br />EHD USE ONLY <br />Street # <br />SttrreeetName City <br />❑ Unit 1 <br />• <br />q� <br />� � V �' � l V'V` It.� �O� <br />2 <br />❑ Unit 2 <br />Unit 3 <br />r4.oe <br />Unit 4 <br />6. <br />7. <br />❑ Unit 5 <br />8. <br />9• <br />❑ Unit 6 <br />10. <br />Specific Date Range of Information Requested: From <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />9 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT 0 SOLID WASTE FACILITYfVEHICLE <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY 0 WASTE TIRE <br />UNDERGROUND TANK (MONITORING/REMOVAL) O DOG KENNEL 0 DAIRY <br />HAZARDOUS WASTE GENERATOR 17 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCK/YARD/CHEM TOILETS <br />d TATTOO/BODY PIERCING 1:3 POOL/SPA ❑ LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY 11 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS. <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 (209) 464-0138 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 $98.00 deposit prior to review. <br />EHD USE ONLY <br />*** If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br />FNn as -06 9/14/2006 <br />