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Dec. 8. 2008 5:41PM <br />DATE RECEIVED"{��/jJ} <br />11 U � � L-/ <br />ur—u 0 9 2008 <br />EWRONMENT ;DEALT <br />Advanced GeoEnvironmentaI No. 3796 P. 1 <br />0 0 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />TelepiTone: (209) 468-3420 Fax: (209) 464-0138 Web: WWW,sjgoV.Or 1 d <br />PUBLIC RECORDS RELEASE APPLICATION <br />C:un i nn–ia—r, <br />83� <br />ADDRESS: IF3 % _/UJ ("c+�d Citylstatelzlp <br />PHONE (1):�Z-off) �3 r (OV 0!).� 3' 1?� FACSIMILE: <br />TENTATIVE* APPOINTMENT DATE: , _ _ Time. T <br />(Please allow 10 businea4 days from date of applieltlon submittal -'Tentative only - mugt he confirmed) <br />CHECK SOX TO EXPEDITE REQ T 105 FFE SH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 12 <br />sir At <br />Electronic Information: ❑List El Map —Description: <br />_ <br />FILE ADDRESS <br />EHD USE ONLY <br />Street # <br />Street Name City <br />✓' +. ❑Unit 1 , <br />i <br />2._ <br />10_. L4.0% /may• <br />ElUnit2 <br />.. <br />4.Iixry�r'�/Joii13 <br />_.. <br />_ <br />Unit <br />6. <br />- <br />--Unit 4 <br />7. <br />nit $ <br />8. <br />�.. <br />_.. <br />❑ Unit6 <br />Specific Date Range of Information Requested: From to ++h+ <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />NDERGROUNi) TANK (UST) CLEANUP SITE (LOP) */H"OU51NG ABATEMENT ❑ SOLID WASTE FACILITY _ C,L� <br />OTHER CLEANUP $ITE (NON -LOP) ❑ FOOD FACILITY Q WASTE TIRE <br />UNDERGROUND TANK (MONITORINo/REMOVAL)O( ❑ DOG KENNEL ❑ DAIRY L <br />❑ HAZARLIO US WASTE GENERATOR - ❑ CHICKEN RANCH 0 WASTEWATER TREATMENT PLA <br />CITIERED PERMITTED FACILITY 173MOTEVHOTEL Q y <br />PUMPER 1RUCKNARDICHRMTOILETS <br />In TATr001B0DY PIERCING ID POOL/SPA ❑ LAIN USE SNIT5 a' <br />❑ MEDICAI WASTE FACILITY 1lbTHER (PLEASE SPECIFY) �� b'Y� �Ik' } F; <br />WELL AND S EPTIC PERMIT REbORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM-$.'ODPM EXCLUDING HOLIDAYS. <br />1- List up to ten a[ldresses 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) 464-0138 or mall to the a address indlcated above, Address <br />ranges will not be accepted - for additional assistance with rile addresses, contact the EHD. Applications received atter <br />3:00 pm will be processed the next business day. <br />2. The ENA will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br />days attar receipt of application. The files will be held for a maximum of five business days for review. Appointment$ <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 tate file is available. <br />4. Any file not returned in the same condition a$ released will be reorganized by EHD staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $106 deposit prior to review. <br />EHD USE ONLY <br />