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DATE RECEIVED SAN JOAQUIN COUNTYEHD LOG NUMBER <br /> 4 � <br /> Ev- ,RONMENTAL HEALTH DEPARTmENT <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> T. lephone: (209) 468-3420 Fax: 209 464-0138 Web: www.s ov.or /eh <br /> ;� ( ) J9 9 <br /> `1 \,VPUBLIC RECORDS RELEASE APPLICATION <br /> AP (�USINE�AGENCY:��t v1, �'63702 <br /> AcZE4 <br /> ADDRES�: 'SSS td, AY'oa S� �}url /D/ CITY/STATE/ZIP: j .� <br /> PHORE (1): ZOif— ize 9 —ZS-S3 P 2): ZG —&IIS- � 3/Z FACSIMILE: ZOF'— <br /> Cay TENTATIVE*APPOINTMENT DATE Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$115.00 FEE(CAS R CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE O!� /3 A0 <br /> Electronic Information: ❑ L' ap—Description: <br /> t� <br /> I FILE ADDRESS tVc. EHD USE ONLY, <br /> Street# Street Name City /p�, <br /> !d'-/04- L Z l�• El Unit 1 <br /> 1 21/03 {�J')�t•�e7t C�4 1�i-DgluC 7ze� .r�. <br /> 2' b ",,et-,- I'4ve� 73.zGc. `l�1C�v+ (� � �i,av►��W�,�y� Unit 2 � <br /> 3' 2 3 o P , . <br /> 4. V� <br /> Unit 3 <br /> 5. <br /> 6. <br /> 7• nit 4 <br /> J 8 ❑Unit 5 <br /> 9. <br /> 10. <br /> nit 6 <br /> Specific Date Range of Information Requested: From 420 to C-C'L.i, <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> t0 1251 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT P9 SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITYn -1 <br /> UNDERGROUND TANK(MONITORINGIREMOVAL),, El DOG KENNEL ��"" ®WASTE TIRE <br /> HAZARDOUS WASTE GENERATOR ' E]CHICKEN RANCH '/// �'('S ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY- ❑MOTELIHOT dG�u � [:1 PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑ <br /> TATTOO/BODY PIERCING POOLISPA LAND USE APPLICATION SITES <br /> to MEDICAL WASTE FACILITY OTHER(PLEASE SPECIF T ' <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR 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 $115.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***If you need further assistance please contact Diane Martinez directly @ (209)468-3425. Thank You*** <br /> Fun en_na <br /> annnna <br />