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FEB-17-2012 07:44 From: To4F4980 Pa9e:1 <br /> DATE RECEIVEDEHO LOG NUMBER <br /> Ur�: SAN .1QAQUIN COUNTY <br /> /1711,2r ENVIRONMENTAL HEALTH DEPAfjhf <br /> C <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209)488-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:IDRIS ATTARWALA BUSINESS/AGENCY: <br /> ADDRESS: 126 RAS'_. C01:1RT _ _ CITY/STATE/ZIP: FREMONT, CA 94536 µ <br /> PHONE(1): 510 300 5064 PHONE(2): 510 445 0300 FACSIMILE: <br /> TENTAT/VE*APPOINTMENT DATE: � h 2 ,,� `� „��n;-Time: <br /> (Please allow 10 business days frpm date of applicati submittal."TentaSve only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQ EST- 125 FE A OR K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE12- <br /> Electronic <br /> ZElectronic Information: ❑List❑Map-Ddii-ription:' <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name city ❑Unit 1 <br /> 12. <br /> 13013 M..TDDLE ROAD TRACY, CA <br /> (also called West Middle) nd2 <br /> 3- 20701 NAGLEE ROAD TRACY, CA <br /> 4. <br /> Unn 3 <br /> s. <br /> $' ( a fl'UnR4 <br /> 7. <br /> 10L9. nk 5 <br /> 13. <br /> 10. <br /> Specific Date Range of Information Requested: From all records to present <br /> ENVIRONNI,ENJAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY EIVASTETIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL PUMPER TRUCKIYARDICHEmuL TOILETS <br /> ❑TATTOO/goDy PIERCING �POOLISPA LAND USE APPLICATION SdES <br /> ❑ MEDICAL WASTE FACILITY COMPLNNTRECORD$ X�OTHER(PLEASE SPECIFY)A11 records <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAEILE FOR REVIEW: MONDAY-FRIDAY 8.00 AM-5:00PM EXCLUDING HOLT AYS) <br /> i. List uo toren addresses in the space above. Select the type(s)of files from the list above by checking the appropria <br /> box(es). At least one file type MUST be selected. Fax W(2091464-0138 ormall.to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received lifter <br /> 3.00 pm will be processed the next business day. <br /> 2. The EHO 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 behold 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$125 deposit prior to review. <br /> EHO U&&ONLY <br /> EHD 4"S 9/ttel <br />