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OCT-21-2009 WED 11 :33 AN nOLLIERS INTERNATIONAL FAX NO. 9`194755102 P. 01/01 <br /> _`- <br /> 10/20/2904 15:44201 0138 ENVIR"FNTAL h` fH PAGE 91/91 <br /> SAN JOAQUIN COUNTY END LOO NUMBER <br /> ENVIRONMENTAL,HEALTH DEPARTMENT <br /> OCT 2 2009 600 Fast Main St. Stockton, CA 95202-2708 <br /> Telephone: (209)458.3420 Fax: (208)464-0138 Web: www,algov.org/eh <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> PERMITT SI FRUI, - <br /> APPLICANT: J'�ke 3111 wgLi I BUSINESSIAGENCY: �O LI<'8' ✓� <br /> ADDRESS: $�l3 9 �roekalole !Ce•of w,•IY r ob CITYISTATRIZIP: ;54 d le i-� C.4 <br /> PHONE(1): 7Fq- x/75 /IL PHONE(2): FACSIMILE: ;01- 4/75. 5/08 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Pleaoo allow to bualneea de ye front daW o app atlon eubrrr •• anAatiw only-mvatba con rrn ) <br /> ❑CHECK aOX TO EXPEDITE REQUEST•8115.00 FLESCASH OR CHECK ONLY)-REQUEST PROCESSED IN 5 DUSINESS DAYS <br /> SIGNATURE OF APPLICANT r DATE <br /> electronic.Information: ❑Llat❑Melp—Deacrlpt on: <br /> FILE ADDRESS EHD use ONLY <br /> 6Neet 0 SLnet Man» qty <br /> ❑unit 1 <br /> 2, I:rsa Fislot 0 Qt3db,Nr) �R2 I <br /> 3. <br /> 4. .. un17 a <br /> 5. <br /> 8. <br /> 7. <br /> 9 UnK a <br /> 9. <br /> 10. <br /> Units / <br /> Specific Date Range of Information Roquaa Wd: From to /w� <br /> ENVIRONMENTAL HEALTA DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP&IT(LOP) ®HDua1NQ A9ATEmpff Q SOLID WASTE FAOILRYN5HICI.! <br /> OTHER CLEANUP SITE(NON-LOPE I.J FODD FACILITY I]WASTE TIRE <br /> UNDERGROUND TANK(MONITORNO1 aOVAL)DIL- 00ItEfIH15. DAIRY <br /> HAZARDOUS WASTE GENERATQR l7� - CHICKENRANCH B WASTEWATER TREATMW PLANT IQ/Z <br /> ©TIERED PSIUN"M FACILITY V` MOTEL/1-101111. PUMPBRTRueK/YARDlGNRIIICAL TOILETS <br /> eTA77ODMODY PIERCING ❑PODLIEPA �LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILRY ❑OTHER(PLEASE SPECIFY)) <br /> WELL ANO SEPTIC PfiRMR RECORDS ARE P,VAILAALI=FOR RVAFW MONDAY-FRIDAY 8:00 AM•S:ODPM(EXCLUDING HOLIDAYS) <br /> 1. ) st r e to ten addroogaa in the space abTve, Select the type(a)of tilos from the(let above by ohooking ate appropriate <br /> box(os)• At least one file type MUST be ftolooted, Fax to TjDF14S4•D�a mail to�dtDQg Indketed above Address <br /> rangsa will not be accepted-for additionai aaaistanw with the addreseoa,cantaotthe EiHU. Applications recelvea after <br /> 3:00 pm will he processed the next bushless day, <br /> 2. Thu END will notify the applicant If any END flee Dxlet. An appointment for review will be confirmed approximately bon(10) <br /> day;atter receipt of application. The filo■wifl behold for a maximum of five burin:es days for revlew. Appointments <br /> should be scheduled accordingly. <br /> 5. A file that is actively being worked on by END staff may net be immediately available for review. A new application may bo <br /> submitiod when the the Is available. <br /> 4. Any file not returned In the some condition as released will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the Dame applicant may require a 5115,00 deposit prior to review, <br /> D uaa <br /> ""'If Imu need further assistance l(We contact Diane Martlnex dlrectl 0 (2pg d8-9426. Thank Maur " <br /> 0 — W <br />