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07,/30/2007 12:47 FAX 209 384 82" KLEINFELDER Ij002/002 <br />r <br />DATE RECEiVfuD' " '' `-- / I Efid LOG NUMBER <br />SAN JOAQUIN COUNTY <br />` '''� ENVIRONMENTAL IJEALTH DEPARTMENT <br />T 600 E. Main Street, Stockton, CA 95202-3029 <br />ti' '' ` `' �, ,, •: elephone: (209) 468.3420 Fay: (209) 4638 Web: www$ o r <br />PUBLIC RECORDS RELEASE APPLI ION <br />APPLICANTy 101 <br />ADDRESS: 1"- 1 <br />PHONE (1); ZO 9 Y— PHONE (): ? 4—('S Z - Y.�.1 FACSIMILE: <br />TENTATIVE" APPOINTMENT DATE; 0 Time: 0 <br />(Please allow 10 business days from date of appiloatlon aubmltta - I reMaVve only - must be confirmed) <br />t PI„ `L-,- BUSINESSIAGENCY: <br />W)A-.y . suite-- 4? <br />❑ CHECK BOX TO EXPEDITE REQUEST - $95.00 FEE JCASH 10 OR CHECK <br />SIGNATURE OF APPLICANT - �' 4 A` <br />Electronic Information: ❑ List L] MDs— D®Vorlptlon: <br />FILE ADDRESS <br />$treats street Name Clt <br />BEQUEST PROCESSED IN a t3U$INESS DAYS <br />DATED <br />ECD USE ONLY <br />❑ unit 1 <br />❑ Unit 2 <br />2. <br />3 - <br />Unit 8 <br />4. <br />�. Unit 4 <br />7, 0 Unita <br />B. <br />9 ❑ unit s <br />1M <br />SpaelAc date Range of Information Requested: From <br />Of q*j to <br />ENVIRONMENTAL e EALTe DEPARTMENT FILES <br />V <br />M'UNDGROROUND TANK (UST) CLEANUP SITE (LDP) M HOU5INO ABATEMENT d SOLID WASTE FACIUTYNENICLE <br />In OTHER CLEANUP SITE (NON -LOP) CO FOov FACILITY 0 WASTE TIRE <br />"NDERGROUND TANK (MONITUIRINGIREMOVAL) ❑ DOG KENNEL M DAIRY <br />Z-fWARDOUB WASTE GENERATOR ❑ CHICKEN RANCH Q WASTEWATER TREATMENT PLANT <br />• TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br />d TATTOOIBODY PIERCING ❑ POOLISPA M LAND USE APPLICATION SITES <br />• <br />MEDICAL WASTE FACILITY �THER (PLI.A9E SPECIFY) <br />WDLL AND SEPTIC PERMIT RECOR06 ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM-6:00PM • EXCLUDING HOLIDAYS. <br />1, List Up to ten addraaaes In the space above. Select the typo(s) of flies from the list above by checking the appropriate <br />box(es). At least one file type MUST be aelected.axto - 138 o II to theabove Address <br />ranges will not be accepted — IRr additional aaalstanca with file addresses, contact the EHD. Applications received atter <br />3:00 pm will be processed the next business day. <br />2. The EHD will notify the applicant If any EHD files exlet An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will be hold for a maxlrnum of five bueinas9 days for review. Appointments <br />should be scheduled accordingly. <br />3. A Ale that 16 actively being worked on by EHD ataff 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 some 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 $96.00 deposit prior to review. <br />FRO USE ONLY <br />