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r <br />LHU LUU NUMULK <br />rE RELIVE° -1 SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT fa `- -` <br />600 East Main St. Stockton, CA 95202-30 <br />Te�Thone: (209) 468-3420 Fax: (209) 464-0138 Web w ii) -6' rg/ehd�/ <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT:�+0�� C BUSINESSIAGENCY: 1= CM 92-(oZ(I <br />ADDRESS: 3�J2 ✓2 ZOO CITYISTATOE�2Cilia �° �j <br />PHONE (1): Fj (o - 3� PHONE (2);510-(a -ip2(o0 FACSIMILE:510-2615- 2inS(o <br />TENTATIVE* APPOINTMENT DATE: (=( i A A1A u k 2.: `Lo i O Time: 8 Ayv-\ <br />(Please allow 10 business days from date of appllcaU subm 'T ve only -must be confirmed) <br />STACHECK BOX TO EXPEDI QU • $115 FQfjJASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BU INESS AYS <br />TURE OF APPLICA GATE C9 Z <br />F <br />�3 <br />r.'..i�jf0j4r,# EHO USE ONLYUnit 1 <br />lug <br />! NPIT-1711 <br />c�I <br />Specific Date Range of Information Requested: From P I Y_ l I -CJ'i ` __ ' p -se In <br />ENVIRONMENTAL ALTH DEPARTMENT FILES <br />I <br />NDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE�� <br />OTHER CLEANUP SITE (NONLOP)❑ FOOD FACILITY ❑ WASTETIRE <br />NDERGROUND TANK (MONITORING/REMOVAL) dL­ ❑ DOG KENNEL ❑ DAIRY t <br />HAZARDOUS WASTE GENERATOR � ❑ CHICKEN RANCH ASTEWATER TREATMENT PLANT <br />IERED PERMITTED FACILITY (71- E]MOTELIHOTEL M,PER TRUCKNARDICHEMICAL T01 A <br />❑ TATTOO/BODY AFRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES �1 <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 1209) 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 EHD wili 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 <br />Future file reviews by the same applicant may require a $115 deposit prior to review. <br />S. If you need further assistance, please contact Diane Martinez, at (209) 468-3425. <br />