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w uVU V�,Yf N NUI c1l JUL 41 b-252-8985 p.1 <br />QVED <br />L ,4 . SAN JOA UINCOUNTY 40 <br />EHD LOG NUMBER <br />MAR 4 5 2008 ENVIRONMENTAL HEALTH DEPARTMENT <br />O53 <br />600 East Main Street, Stockton, CA 95202-3029 <br />ENVIRONi E'NT HTelephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.or d <br />pE,9rvi1T/SFRv[ <br />_ 9 PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: <br />BUSiNESSfAGENCY: <br />ADDRESS: i �4� 4- AU irr� vir.(3Co I <br />PHONE (1): _Z q Q - �?Si?j PHONE (2): �'7� " Z' �����jFACSIMILE:14 <br />TENTATIVE" APPOINTMENT DATE: �A�i L�' Time: - ��_iM <br />(Please allow 10 business days from of applickion submittal -'Tentative only - must be confirmed) <br />❑ CHECK 130X TO EXPEDITE REQUESTIPOPO FE ASH OR 9AECK ONLY) - REQUEST PROCIESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT _ DATE hV-6 <br />Electronic Information: ❑ List ❑ Map — <br />11 <br />Specific Date Range of Information Requested: From Som I Z (nyl <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />M UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT CI SOLID WASTE FACILITY/VEHICLE <br />❑ OTHER CLEANUP SITE (NON -LO P) ❑ FOOD FACILITY ❑ WASTE TIRE <br />© UNDERGROUND TANK (MONITORING/REMOVAL) 0 DOG KENNEL ❑ DAIRY <br />C1 HAZARDOUS WASTE GENERATOR CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br />13 TIERED PERMITTED FACILITY d MOTELiHOTEL C7 PUMPER TRUCK71(ARDICHEM TOILETS <br />❑ TATToo1BoDY PIERCING Cl POOLISPA C1 LAND USE APPLICATION SITES <br />G MEDICAL WASTE FACILITY Ci 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 t)pes) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (2091464-0138 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 far 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 t1SE ONI v <br />