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bk- <br />6V_ <br />i <br />11,11TIMENED SAN JOAQUIN COUNTY END LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT— <br />mob. <br />AUG 2 0 2007 600. East Main Street, Stockton, CA 95202-3029 <br />Tele hone: (209) 468-3420 Fag: (209) 464-0138 Web: www.9 0 d <br />ENVIRONMENT HE <br />PERMITJSERVI'E$PUBLiIC RECORDS RELEASE APPLICATION <br />APPLICANT: G -Y VT i t�f�.p - BUSINESSIAGENCY: 5I6 t?A.. b EA_TA, cze g FD. <br />ADDRESS: <br />PHONE (1): $57. Z L'P, /�.'S/ PHONE (2): FACSIMILE:~ - <br />TENTATIVE' APPOINTMENT DATE: Tamm: <br />(Please allow 10 business days from date of application submittal-•Tentadve only - must be confirmed) <br />O CHECK BOX TO ExPEDiTE. REQUEST .;Ilapa F_r.V(49SH. Cjh CHECK ONLY) - MQUEST PROCESSED M. 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />Electronic Information, 0 List ❑ Map - Descri <br />Street >M <br />7. IN9� <br />2. <br />3. <br />4, <br />Name <br />DATE f%7 -2-0-07;L <br />t EHD USE ONLY <br />(tSTl6 ) ; 14Jj �pv%(61 13 Unit 1 <br />\ ❑ Unit 2 <br />Ind a' <br />5. (�Unit t <br />6, <br />7. <br />® Unit 6 <br />a- <br />10. <br />Specific Date Range of)nformatlon t`tagU63ftd.' From /941", to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />X UNDERGROUND TANK (UST) CLEANUP SnE (LOP) 0 HousiNo AsmamaKT SOLID WA31E FAc1LrrvNeHicte <br />OTHER CLEANUP SrrONO"OP) 17 FORA F^Acam I WASTE. TIitE, <br />UNORKOROUND TANK (MONITORING/REMOVAL) 13 Doe KPWSL, 13 DAIRY <br />HAZARDOUS WASTE GENERATOR 13 GHicKSN RANCH 13 WASTEWATER TREATMENT PLANT <br />TIERED PERMITTED FAMMY O MOTELIHOTEL CI PUMPER TRUCK)YARO/OKM TMLM <br />I� TAYTOO/BODY PIERCING 13 POOL/SPA 13 LANG USe APPLICATION SITES <br />17 M01CAL WASTE FACILITY Q OTHER (PLEASE SPECaFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RLNIEW - MONDAY -FRIDAY 8:00 AM-5:00PM - CXCLUOMa HOLIDAYS. <br />1. Ust up to tan addresses in the space above. Select the type(s) of fills from the list above by checking the appropriate <br />box(as} At least one file type MUST be selected. Fax to Q09) 464.4138 ar mail to the address tndlestod above. Address <br />ranges will not be accepted -for additional assistance wine the addresses, contract the END. Applications received after <br />3:00 pm will be processed the next business day, <br />Z. The END will notify the applicant if any END files exist An appointment -for review will he confirmed approximately tett (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 END 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 END staff at the expense of the applicant <br />Future file reviews by the same applicant may require a $98.00 deposit prlor to review. <br />END USE ONLY <br />M M -41I P <br />I' d ZSt► T -622-SSS- T dJ03 e4 I aQ e,JJa 1 S <br />0112:130 GO 02 Znb <br />