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11-Jan-2006 02:25pm From-Younlldahl sultina Group. Inc 916 933 6482 T-232 P.001/00' F-779 <br /> Q9, <br /> YE RECEIVED EHD LOG NUMBER <br /> SAN JoAQuuv COUNTY <br /> ENVIRONMENTAL HEALTH)DEFARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 to k <br /> Telephone: (209)468-3420 Fax: (209)4640138 Web:www.sjgov.ore/ehd �/(J <br /> ` PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: L� <br /> a(. ri-e j_9r4BUSINESSIAGENCY: 0 � tom/ S/�tr7J�7(j <br /> ADDRESS: 05 ✓1t�i1 m,#P-}} bnkra C,4 <br /> 9.S•�l0 �/ <br /> PHONE I1):�_�1_J l'J ' D �j,PHONE(2):<QI�O� Yl��a7�7 �d( FACSIMILE• / .�^b Y�� <br /> TENTATIVE'`APPOINTMENT DATE: Time: _ <br /> ,,,/ (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> of CHECK BOX TO EXPEDITE 13 T-$93 u0 EE(C75R CH K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DA <br /> SIGNATURE OF APPLICANT— DATE <br /> c ; <br /> UNIT DISTRIBUTION D Unit 2 ❑ Unit 3 ❑Unit 4 ❑Unit 5 0 Unit 6 M other(clectronic/list:lmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Strect Name city <br /> 1. Loo Char7Le.-- vVaxiSacci: h t <br /> 2. 1 Q 45D 1 0.70--/er h <br /> 3. O r-IrJ <br /> 4. 1�Q / a tdq !>,c V C <br /> 9. <br /> 10- <br /> Specific Date Range of Information Requested:From ALIW <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> CCCZ�ZJ(�1NOERGRoumo TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATER I1SOLID WASTE FACIUTYNFNI E <br /> uM CLEANUP Smt(NON-LOP) 11F000 FAc1uw InWASTE TIRE <br /> wynDERGROUNO TMK(MONCTORINWREMOVu) M DOG KENNEL ❑DAIRY <br /> HAZARoous WASTEGENERATOR ❑CHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> O TIERED PERMCMD FACILITY O MOTEtMOTcL ❑PUMPERYRUCK(YARDICHEM TOILETS <br /> ❑TATTGoMOOY PIERCING ❑POOLISPA ❑LAND USE APPLICATION 3n 5 <br /> 0 MCMCAL WASTE FACT n 13 OTHER(PLEASE SPEOIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW . MONDAY-FRIDAY 8:00 AMS:00PM - EXCLUDmG HOUDAM. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses, contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exisL An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments 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 <br /> application may be 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> CND w mans <br /> 111 o3 <br />