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10/06/2008 17:33 91656\ � *111110111' I.O <br /> ?2 KRAZAN PAGE 02/02 <br /> 11 EMD G NUMBER <br /> SAN JOAQUIN COUNTY <br /> OCT O S 2008 ENVIRONMENTAL H.EAI.TH DEPARTMENT <br /> E00 East Main Strect, Stockton, CA Web: <br /> Nv2708 '�970Y <br /> ENVIRONMENT HEALTH Telephone: (209)468-3420kaX: (209)464-0138 Web: wwwsjgov,or <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: r^ /* r*�f(' 'T__SUSINESSlAGENCY: rVf/ iT�* YL/75 �.;•; <br /> ADDRESS: q.7 F• /•?�1"/L.�Y I � ytl�/p rOS�! <br /> PHONE(1): /IP �0� �d"7490 PHONE(2): SIU/ f7>^7] Zb9l FACSIMILE:9�b gg • • <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal *Tentative- only-must be confirmed) - <br /> CHECK BOX TO EXPEDITE REQUEST-$98.0 E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 9U NE DAYS <br /> SIRE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# _ Street Name City ❑ Unit 1 <br /> Vgy m/$Tom— OC d ✓/ <br /> U 2. - e�7 e"I S r ST�KT,v/ • 0 ❑ Unit <br /> s. 5 .-. STr�C (�70 o co yi <br /> ;.. <br /> 4, <" <br /> _ a <br /> 5. a Q <br /> 7. <br /> low% Uzi_._ ❑ unit 5 <br /> B. <br /> 9. <br /> :. f` _— unil6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 3 F1 1P5`O/ <br /> 40. NDERGROUND TANK(UST)CLEANUP SITE(LOP) V HOUSING ABATEMENT SOLID WASTE FAC0.ITYNEHICLE UA�.t 77 <br /> J4"1'�DTHER CLEANUP SITE(NON-LOP) C FOOD FACILITY O WASTE TIRE 1 <br /> An�L'I'NDERGROUND TANK(MONITORING/REMOVAL)t< O DOG KENNEL O DAIRY MAX <br /> ;e-gAZARDOVS WASTE GENERATORQ( 0CHICKEN RANCH d WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY 0 MOTELIHOTEL 11 PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTOO/BODY PIERCING 0 POOLISPA ❑ LAND USE APPLICATION SITES <br /> M MEDICAL WASTE FACILITY O 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(2091 464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted for additional assistance with Ole 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 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$98.00 deposit prior to review. <br /> _ EHD USE ONLY <br /> *** <br /> If you should need further assistance please contact Diane Martinez @ (209)468-_3425 directly. Thank You*** <br /> B r v' ¢ Otni 4y caw-P-6 /�? U42/144--'71: 6� <br />