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Nov -16-2011 03:19pm From -URS CORPORATION 2153671000 T-853 P 001/001 F-244 <br />EHD LOG NUMBER <br />V E ru' "' 0 SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />0/ 16 2011 600 East Main St. Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wwW.Sjgov.org/ehd <br />ENVIRONMEN YAL. HEALTH <br />PERMIT/SERVICES <br />PUBLIC RECORDS RELEASE APPLICATION <br />BUSINES (AGENCY: Ll <br />APPLICANT:—,U-61 [ Q- 3 <br />�.4m � �, � CITYlSTATEIZIP: a <br />ADORES$: FACSIMILE: 01 <br />PHONE (1): l - 6 a,lbl PHONE (2): Time: <br />TENTATIVE' APPOINTMENT DATE: <br />(Please allow 10D TF- REQl1EST ys $125 EB (CASHate of 1ORICHECK ONLY) •TREQUE=ST PROCESSED IN 3 BUSINESS DAYS <br />Fj CHECK BQX TO EXPEDITE DATE 1114, 11 <br />SIGNATURE OF APPLICANT <br />Electronic Information: j] List nMap - Description: <br />EHD USE ONLY <br />FILE ADDRESS - <br />Street # Street Name <br />�• `jO^S o-$1" Unit <br />2. <br />3. Unit 3 <br />4. <br />5. Unit 4 <br />s. <br />8. <br />9. unit 6 <br />10. to <br />Specific Data Range of Information Requeeted: FrOM ONMENTAL H1 ACTH AEPARTMENT FIG.ES 'J <br />Q <br />HOUSING ABATEMENT SOLID WASTE FACILITY[VEHICLE L 77 <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) FOOD FACILITY WASTE TIREUP( <br />ML. C]OTHER CLEANUP SITE (NON -LOP) DOG KENNEL DAIRY 11 , ZGI J <br />UNDERGROUND TANK (MONITORINGIREMOVAL)N ❑ C] WASTEWATER TREATMENT PLANT <br />HAZARDOUS WASTE GENERATOR C3 CHICKEN RANCH F1 PUMPER TRUCKIYARDICHEMICALTOILETS <br />TIERED PERMITTED FACILITw <br />D - ❑ pOOLISPAT�L MOLAND USE APPLICATION SITES <br />Q LISPA <br />T41700113ODY PIERCING �] COMPLAINT RECORDS Q OTHER (PLEASE SPECIFY) <br />MEDICAL WASTE FACILITY <br />_... nrnur RernRnS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 5:00 AM•5:00PM (EXCLUDING HOLIDAYS <br />vvt;l-1- AMU VF- r iw ......... . _-_ _ _ _ <br />1 U u to an ad teases in the space above. Select the type ($) o#files from the lista ave Y e <br />box(es). At least one file edp for additional ass $fence with file 4-0138es, contact he EHD or mail to the gApplicat ns receiv d after$ <br />ranges will not be accept <br />3:00 pm will be processed the next business day, e confirmed approximately ten (10) <br />2. The EHP will notify the applicant if any EHL] files exist. An appointment far review will b <br />ays far review_ Appointments <br />days after receipt of application, The files will be held for a maximum of five business d <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. locant, <br />4. Any file not returned In the same conditio <br />n as released will be reorganized may require a $125 deposit prior toreview. Dtaff at the expense of the app <br />Future file reviews by the same app - A I , A 1 I-' SIc <br />a fffm <br />