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04/23/2007 11:27 131079R''941 PAGE 01 <br />r W. RECEIVED EHD LOG NUMRER <br />SAN JOAQUIN COUNTY <br />I_ ENVIRONMENTAL HEALTH DEPARTMENT <br />N :600 E. Main Street, Stockton, CA 95202-3029 <br />2 <br />Telephone: (209) 468-3420 Tax: (209) 464-0138 Web: www.sjgov.o /e <br />737 <br />PUBLIC RECORDS RELEASE APPLICATION <br />_ T G�7 <br />APPLICANT: WEA -WV- BUSINESS/AGENCY:'4-E,--j C0N,5L)LTA"VVS <br />ADDRESS: Zsoo CHm�N0 Mtq--f-f'1'G' SLjj-_"TE 7(n)Q VVLk1,tQVT 02C C.- 0114 <br />PHONE (t). c12S� 2�s`%Cx�l� PHONE(2):(5I 'g(� (QC�(P 2JD, �ZS}�4iGI`�� FACSIMILE:�G <br />TENTATIVE* APPOINTMENT DATE:C.��JIr 2'-I Time: (GDmn <br />(Please allow 10 business days from date of pllcatlon submittal -*Tentative only- must be confirmed <br />Li CHECK BOX TO EXPEDITE REQUEST - $95.00 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 B e <br />N. <br />SIGNATURE: OF APPLICANT '��f _,iG, %�� _ _ DATE I (Z�, <br />Electronic Information: ❑ List D <br />Map —Description: <br />FILE ADDRESS EHD USE ONLY <br />Specific Date Range of Information Requested: From j to <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SHE (NON -LOP) <br />Street # <br />Street Name <br />fte <br />City <br />(4S� V% .Pv11t2 (mac Unit 1 <br />Z —n a G.(�( <br />I� �r�( a� ❑ Unit2sr�ce(1 <br />R WASTE TIRE <br />❑ DAIRY <br />HAZARDOUS WASTE GENERATOR <br />❑ TIERED PERMITTED FACILITY <br />s <br />[4. <br />1900 <br />tJdV Dr+v <br />❑ PUMPER TRUCK/YARD/CHEM TOILETS <br />❑ MEDICAL WASTE FACILITY <br />❑ OTHBR (PLEASE SPECIFY) <br />❑ LAND USE APPLICATION SITES <br />- <<) j�/ Unit 3 <br />U I CA S <br />Unit 4 <br />7. <br />❑ Unit 5 <br />9. <br />Unit 6 <br />10. <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SHE (NON -LOP) <br />❑ HOUSING ABATEMENT <br />❑ <br />)R SOLID WASTE FACILITYIVEHfCLE <br />UNDERGROUND TANK (MONrrORINWREMOVAL) <br />FOOD FACILITY <br />❑ DOG KENNEL <br />R WASTE TIRE <br />❑ DAIRY <br />HAZARDOUS WASTE GENERATOR <br />❑ TIERED PERMITTED FACILITY <br />❑ CHICKEN RANCH <br />❑ WASTEWATER TREATMENT PLANT <br />❑ TATTOOIBODY PIERCING <br />❑ MOTELfHOTEL <br />M POOLISPA <br />❑ PUMPER TRUCK/YARD/CHEM TOILETS <br />❑ MEDICAL WASTE FACILITY <br />❑ OTHBR (PLEASE SPECIFY) <br />❑ LAND USE APPLICATION SITES <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. F c 209 464-0138 or r0ail to the address n 'cated above. Address <br />ranges will not be accepted — for additional assistance with file addresses, contact the FFD. 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 $95.00 deposit prior to review. <br />rHn Imp nmi v <br />r4_ <br />J <br />w <br />