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11/01/2007 15:38 FAX . Z002 <br /> O E1 =PV O EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> NUV 0 1 2007 ENVIRONMENTAL HEALTH DEPARTMENT 1 <br /> 600 East Main Street, Stockton,CA 95202-3029 r 00 <br /> M RONMENT HEAL%Iephone:(209)468-3420 Fax: (209)464-01391 www.s go eh�( <br /> PERMIT/SERVICES <br /> yy v yPUBLIC RECORDS RELEASE APPLICATIO <br /> APPLICANT: f1�1'('I� / Tr�F,,rnJ�����v�ypAI Q'�� _DUSINESSIAGENCY: <br /> ADDRESS: /�'1 1 '$' Trwv"or-- - � FM �ctw. x--01 606 --� �1,Vv�-� <br /> PHONE(1): (a-I3� '"143- J 1 PHONE(2)::} yYNN�����II FACSIMILE:Loa!, ) q S jE I <br /> O <br /> TENTATIVE`APPOINTMENT DATE: WIOti , ?M - Time: II.Oy a'w\,- <br /> (Please allow 10 business days from date of application submittal-'TentaiWe only-must be confirmed) <br /> *CHECK BOX TO EXPEDITE REQUEST- 99. FE C OR CHEC ONLY)-REQUEST PROCESSED IN 3 EISI ESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ LISt❑ Map— crlption: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> ��05 Lik�7>zt�[A ST. LStALON <br /> r3.44. <br /> ❑ Unit �( <br /> Unit 4 <br /> 6. <br /> 7• ❑ Unit5 <br /> 8. <br /> 9. VA j A& ❑ Unit6 <br /> 10, <br /> 51j& <br /> Specific Date Range of Information Requested:From --I u � v IQI L a� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 13 SOLID WASTE FACILITYIYEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> 'ECUNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> O HAZARDOUS WASTE GENERATOR 11 CHICKEN RANCH O WASTEWATER TREArMENT PLANT <br /> O TIERED PERMITTED FACILITY 0 MOTEUHOTEL 11 PUMPER TRUCKIYAr:DrCHEMYOILETs <br /> 0 TATTDaBooY PIERCING 0 POOL/SPA 0 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILn,r 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-S: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(2091464.0138 or mail to the address indicated 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 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 /> EM M46 wee B180007 <br />