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03/30/2010 09:19 <br />I,IAR 31 2010 <br />2093338303 LODI DOWNSTAIRS - PAGE 02/02 <br />EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT WOW <br />600 East Main Street, Stockton, CA 95202.3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: ww ro-jgov.org <br />ENUIRuiu1VIEr�T HEALTH <br />PERHEALTH <br />HEAL PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: _Tln.a_Ch�Ll_y _ BUSINESSIAGENi;Y: <br />ltylStatetzip o74Q <br />ADDRESS: �0z1nduStrlalW <br />PHONE (1): � 21L1=17DJ-----.— PHONE (2): FACSIMILE: <br />TENTATIVE* APPOINTMENT DATE: 03-31-10 Time: 921111 <br />(Please allow 10 business days from date of application submittal -*Tentative only -must be confirmed) <br />11 ruary anY Tn KxPEDITE REQUEST - $105 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />DATE <br />4-12-10 <br />Electronic Information: ❑ List ❑ Map - Description: _ I <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT rK.ES <br />/UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT 0 :;OLID WASTE FACILITYNFHICLE UP <br />171F000 FACILITY 0 WASTE TIRE <br />'OTHER CLEANUP SITE (NON^LOP) C1 DOG KENNET. ❑ DAIRY <br />�LUNDERGROUND TANK (MONITORINGIREMOVAL) /� p WASTEWATER TREATMENT PLANT <br />HAZARDOUS WASTE GENERATDR� 0 CHICKEN RANCH <br />❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL 0 PUMPFR TRUCKNAROICHEM TOILETS <br />❑ TATTOOIBODY PIERCING 0 POOLISPA 12 LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) „ <br />WELL AND SEPTIC PERMIT RPCORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM-5:OOPM - 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 (209) 4640 38 or mail to the address indicated above,_ Address <br />ranges will not be accepted -for additional assistance with file addresses, contact the EHO. 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 $105 deposit prior to review. <br />EHD USE ONLY <br />