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ul.i—bb-2dby 12:31 P.22 <br /> "TO EHD LOG NUMBER <br /> RE <br /> SAN JOAQUIN COUNTY <br /> (� (� <br /> X11 V� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 6 2009 600 East Main St. Stockton, CA 95202-3029 �''/) <br /> �i•I ( Telephone: (209)468-3420 Fax: (209)464-0138 Web:WWw.SJ90V.O4e / <br /> ENVIRUI.,,nrT ni"F0,HEALTPUBLIC RECORDS RELEASE APPLICATION 1 ` <br /> PER ../ � <br /> APPLICANT: �USINESSIAGENCY: g <br /> ADDRESS: 414ti CITYISTATE2IP: 1W z93 a— <br /> PHONE(i): PHONE(2): 1 _ FACSIMIL <br /> lh�,,,/1 <br /> TENTATIVE*APPOINTMENT DATE: Time: d <br /> je(f/',tW� " (Please allow t0 business days from date f eppl cat on submittal-"Terdatrve only-must be eoMlnned <br /> 10110/91 --,PXCHECK BOX TO EXPEDITE REO T-S FE C H CHECK ONLY)-REQUEST PROCESSED IN38LJSINES5DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: [I List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street a Street Name Clly ❑Unit 1 <br /> 1• "!o / o p 0 tA15 <br /> 2. CiY o G. 1, ❑u <br /> 3. 3 014. Maaaae, a, , coly�'Q <br /> 4. 40&T aany G✓1 nIt3: <br /> 5. BGS,NDUnrh�aYyP <br /> 6, tp 10 eIt <br /> T. w uy o�s,No(cnir3uy <br /> B <br /> El unit 5 10 <br /> 9. <br /> 10. ❑Unit a <br /> Specific Date Range of Information Requested: From to <br /> �/ ENVIRONMENTAL HEALTH DEPARTMENT FILES J /� <br /> U✓ ERGROUNn TANK(UST)CLEANUP SITE(LOP) F1 HOUSING ABATEMENT E]SOLIDWASTE FACILITYNEHICLE 0"r <br /> �(r <br /> ER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ERGROUND TANK(MONIT ORINGIREMOVAL) F]006 KENNEL El DAIRY <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEIIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTO01BODY PIERCING ❑PDOt15PA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS 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 091 464-0138 or mail to the address in 'rated 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 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 stall 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$115 deposit prior to review. <br /> 5. N you need further assistance,please contact Diane Martinez,at(209)466-3425. <br /> Re,Elle d!ONLY <br /> e, <br /> ( e <br /> EHD C 6 8/27101 <br /> TOTAL P.02 <br />