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u�i_lyT�ee� 15:5U CUULDWELL-HLEHSHNIUN 9254160175 P.01i01 <br /> R"'ECEVED EN .SRO MEN AL HEALTH DEPARTM. T <br /> n� 600 E=ast Main St. Stockton, CA 95202-3029 <br /> OCT 1 9 '49lephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov. hd <br /> EHVnR NNIENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> Coldwell Banker Residential <br /> APPLICANT: Romar De Claro BUSINESS/AGENCY: Brokerage <br /> ADDRESS; 5980 Stonerldge Dr.,#122 CITY/STATE/ZIP: Pleasanton, CA 94588 <br /> PHONE (1): (925)847-2315 PHONE(2):(925)784-3068 FACSIMILE: 800 914-3054 <br /> TENTATIVE'APPOINTMENT DATE: November 3, 2009 Time: 1:00 p.m. <br /> (Please allow 10 bus s aye from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDIT RE U -$115 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPL.ICAN DATE �0--ka '0q <br /> Electronic Information: ® Lis Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# street Name City Unit 1 <br /> 1. 10900 E.Tokay Colony Lodl <br /> 2. . (Docket#2007-167837 and any&all <br /> 3. records associated with this docket#) <br /> 4. � - nit 9 <br /> 5. ^ <br /> 6, nit a <br /> 7. <br /> 9. - <br /> 10. Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRON AL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE:(LOP) &HOUSING ABATEME=NT ❑SOLID WASTE FACIUTYNEHICLE <br /> ❑OTHER CLEANUP SITE(NON-IAP) fnOOD FACILITY ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> []HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEL/HOTEL []PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> ❑TATroo/BODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑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 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 mall to the address indt sled 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 deposit prior to review. <br /> 5. If you need further assistance, please contact Diane Martinez,at(209)468-3425. <br /> EHO USE ONLY <br /> TOTAL P.01 <br />