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w14pr. 1 7007 12:27PM <br />�7r t�3 Do <br />', � <br />3 u � L� <br />P � /SERVIGES <br />Advanced Geohv i ronment-a- ._ <br />,SAN JOAQUIN COUNTY <br />No. 8130 P. <br />ENVIRONMENTAL HEALTH DEPARTAIEENT <br />304 East Weber Avenue, 3"d door, Stockton, CA 952022708 <br />Telephone: (209) 468-3420 )Fax; (209) 464-0138 Web: www.sjgov.org/ehd <br />PUBLIC_ RECORDS RELEASE APPLICATION <br />I <br />BUSINESSIAGENCY:..LUuQnC d&A&V1n }?'AP_J)�qJ <br />,A <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please'allow t0 business days from date otapplication submittal -'Tentative only- mutt be confirmed) <br />Y <br />NLEcK BOX TO EXPEDITE RE T - $95.00 FEE (G AOR G SCK ONLY) -REQUEST PROCESSED IN 9 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 7 <br />Electronic Information: ❑ List ❑ Map— Descrlptlon: <br />SpoCitiC nate Range of Information Requested: From to <br />,J ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />I� UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HouslNG ABATEMENT 1:3 SOLID WASTE FACILITYNEHICLE. <br />.�y OTHER CLEANUP SITE (NON -LOP) M F000 FACILITY 0 WASTE TIRE <br />.f UNDERORDUNDTANK (MONITORINCIRkMOVAL) Gi DOG KENNEL 17 DAIRY <br />y7�HAZARDDus WASTE GENERAT017 12 CHICKrx RANCH C7 WASTEWATER TREATMENT PLANT <br />�j TIEPTD PERMITTED FACILITY d MOTELIHOYELMPER TRUCKIYARDICHIPm TOILETS <br />TATTOD180DY PIERCING a POOLISPA AffLAND USE APPLICATION SrTES <br />C] MEDICAL WASTE FACILITY C] OTHER (PLEASE SPECim W <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8;D0 AM-S:QAPM - EXCLurmn HouoAYs. <br />9. List up to ten addresses in the space above, Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected, Fax to 208) 464-0138 or mail to the address indicated above. Address <br />ranges will not be accepted — for additional assistance with file addresses, contact the EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. The 1tkt) will notlfy the applicant If any EHD file$ exist. An appointment for review will be confirmed approximately ten (10) <br />days after receipt of applicatlon. The flies 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 EmD staff may not be Immediafely available far review. A new application may be <br />submitted when the file is available. <br />4. Any fife not returned in the same condition as released wail be reorganized by EHO staff at the expense of.the applicant. <br />Future file reviews by the same applicant may require a $95.00 deposit prior to review. <br />LFIII IIRF nhll V <br />