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07/02/2007 10: 16 FAX (A 001/001 <br /> DATF RECEIVED EHD LOO NUMBER <br /> rl -'' r J ,, ;,r i�l SAN JOAQUIN COUNTY <br /> l�'`= +; " • J/ ENVIRONMENTAL I-IEALTII DEPARTMENT <br /> 7600 <br /> E. Main Street, Stockton, CA 95202-3019 <br /> 2007 Telephone: (209)406-3420 Fax:(209)164-0138 Web: wwwsjgov.nrF/ � <br /> , 'iiF' PUBLIC RECORDS RELEASE APPLICATION <br /> A PIGANT, ,.,, ., . r S� RL(.z 7 <br /> BUSINESSIAGENCY: DEL CCrr �.ht f-T <br /> ADDRESS: 5Lvt-p ��'r"r'�t PILyvE f�t9^t q—r Wmcogpyisfmoo <br /> d (r <br /> PHONE(11:=116 503 I7-69 PHONE(2): 1116 x_4.6 9301 FACSIMILE:_m6 63P Sm5r <br /> TENTATIVE'APPOINTMENT DATE: P i mr ;E Tune: Iq N y <br /> (Please allow 10 business days from date of application submittal-•Tentative only-must be confirmed) <br /> O CHECK BOX TD EXPEDITE REQUEST <br /> ,,"5-00 FFr(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT L''% DAA <br /> P <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> SlreeL it _ Street Name- -- - City ❑ unit 1 <br /> 1. E . MR2DfNlr W n7 ra���Dom, s sHaw <br /> Gsoo S 2 S �/4%NIZOP <br /> P. <br /> . <br /> y E] Unit <br /> Ib4:70 GMisamE wed Dill 10.4 <br /> T <br /> 1. <br /> 7Sor . <br /> until �U <br /> �6ob 20, 5Tvckr r> f` \ <br /> pig 23?� T66CY /3Lvp, rJ T2Rcy (Asti sM Ewl Unit <br /> B• - -- - - - ^` ❑ unit 5 <br /> ���CX����' -- - - ❑ units <br /> ' r V equested:From R L L to U, <br /> ,S T - 5 NVIRONMENTAL HEALTH DEPARTMENT FILES <br /> C E(LOP) n HOUSING A^ATEMENT 13 SOLID WASTE FACILMMENICLE <br /> (3 FOOD FACILITY 1`1 WASTE nRE <br /> NAL) O DOG KENNEL ❑DAIRY <br /> 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Ef TIERED PERMITTED FACILITY O MOTELMOTEL ❑PUMPER TRUCKTY D/CNEM T,HLETS <br /> EI TATTOOfBODY PIERCING ❑PDOLISPA rT LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL ANh SFvnC PERMITRECORUS ARE AVAILADLEFOn REVIEW• MONDAY-FPoOAY 6:00 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 09 464.0136 or mail to the address indicated above. Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the END.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$95.00 deposit prior to review- <br /> _ EHD USE ONLY <br /> EH04646 Ovlmow web .- <br />