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DATE RECEIVED 0 <br /> SAN JOAQUIN COUNTY EHD Loo NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 CA 95202-302 <br /> Telephone: ( 9)468-34201Fax: (209)4648t, Stockton,38 Web: www sjgOv. d <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ( C ti{ 1 oQ h 61 <br /> �t:ss: ti N aro�, GJ ���, BusrlvEss/aGENCY; <br /> AoaR <br /> �G'g �i 1` GitylStatel2'ip 6<b <br /> PHONE(1); L <br /> 1 _�Goo� PHONE(2): 7_0� n <br /> FACSIMILE, <br /> TENTATIVE"APP0114TMENT DATE: ~O ' F-3� <br /> (Please allow 14 business days from data o application tubmittal••1 E,nfative onlylmn,ust be canfir_ad) <br /> CHECK BOX TO EXPEDITE RLQUE - 05 F �AR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE /�— <br /> Electronic information., 0 List❑Map--D $Cription: <br /> FILE ADDRESS EHD USE DNLY <br /> Stroat# Stroet Name <br /> j ,�• City <br /> SO(4 CGtC.iD,?,2 &tg �{ ,� � Lt7 5 El unit l �� <br /> 2. � !rl Tin .� p LG 54 LICA/ Q Unit2 <br /> �7 1027 Iv SA be., 02 Rte, ca C# <br /> 4. S` <br /> I � <br /> 6. - i ° � � Unit <br /> 7. <br /> 8. ❑ Unit 5 <br /> 9. <br /> 1t). Unit 6 <br /> Specific Date Range of information Requested.From to dmf <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> -,UNDERGROUND TANK(UST)CLEANUP SITF(LOP) 0 HOUSINU ABATEMENT ❑SOLID WASYE FACiLITY)VEHICLE y�2 <br /> ;r4THER CLEANUP SITE(NON-LOP) a FOOD FACILITY M WASTE TIRE �{�r+ 1 <br /> Of UNDERGROUND TANK(MONMORINGIREMOVAL)in 0 Doa KENNEL 0 DAIRY. <br /> °°r FIAZARDGUS WASTE GENERATOR i7(, 0 CHICKEN RANCH 'L]WASTE WATER TREATMENT PLANT �f Vol <br /> C]TIERFE)PERMITTLO FACILITY M MOTELIH07EL C3 PUMPER TRUGKJ ARDIGHEM IGILETS <br /> C TATYOOIBDDY PieRcwia ❑POOLISPA CJ LAND USE APPLICATION SITES <br /> ❑MEDICAL WA$YL FACILITY O C)THCR(PLEASE SPECIFY) <br /> WLLL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REv1Ew- MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAY$. <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(2091464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with fiie 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 hold 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 he <br /> submitted when the file Is available. <br /> 4. Any file not returned in the same condition as releasod will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> EHD USE ONLY <br /> oc , <br /> EHD 48.06 8104108I j <br /> PUBLIC REC;,9EAPPFORM. I <br /> Z0 39dd NOdIN039N-3 96Z166560Z Tb:TT 8002/LT/ZT <br />