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AP r. 23. 2008 11 :03AM ,anted GeoEnVlronmental No. 1830EHDP'__11LIMSER <br /> DATE Kt:t.CIVCU <br /> ` SAN JOAQTJIN COUNTY ~ <br /> ENVIRONMENTAL, HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> APR � 8 2008 Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> En,�;isu"` '1=1`)T 'iEFLTN PUBLIC RECORDS RELEASE APPLICATION <br /> PE tP. Manu (' � r'�(oaMceil (-, rZ <br /> APPLICANT: �(Y/Zdn/A��ZGI BU$INEHBIAGENCY: <br /> ADDRESS: �J? 7 Shy/ 7L-e�FL4 <br /> PHONE(1): PHONE(2)7 /i%U'l —,l,'06 7 FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application Submittal-"Tentattve only-must be confirmed) <br /> HECK BOX TO EXPEDITE REQU -$98.00 FTJ( SH OR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAY <br /> SIGNATURE OF APPLICANT DATE -23 -Q__ <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS __ . _ EHD USE ONLY <br /> street# Street Name City *� El t 1 <br /> o�S �6.r �� sty - GM - ll d266-S` E�75r IfleeeC. 5>41 ito et, -vw 5c- v075 /.�/e �"•2 5fnw' t 3 <br /> 11Oyy10✓ o�7/-1- ��IGEf \ k46. <br /> 7t 8 <br /> g' Unit e <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> .� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 4 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E3 HOUSING ABATEMENT -9SOLID WASTE FACILITVNEHICLE <br /> 13 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> l!"NDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL M DAIRY <br /> 4"AZARDOUS WASTE GENERATOR ❑CRICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDICHEMTOILETS <br /> TATTOO/BODY PIERCING 171 POOL/SPA ❑ LAND USE APPLICATION SITES <br /> C3 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-B:DOPM - EXCLUDING HOLIDAYS. <br /> 1. List up t0 ten addresses in the space above. Select the type(®)of Nies from the list above by checking the appropriate <br /> box(ss). At least one Nle type MUST be selected. Fax to(209)464-0138 or mall 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 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 4"0 WEB 8&2007 <br />