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V Nov. 4, 2008 1 :00PM Fwanced GeoEnvironmental No. 3523EHDP. IIvUMeER <br /> DATE KtCtIVEu • SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL REAI.TU DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> NOV 4 2008 Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> � � ^ � yi <br /> APPLICANT: lIV colAyi BUSINESSIAGENCYAghahCLd Deva— rt+n 6t/ <br /> ADDRESS: S11a� Read &tVCV-+Vh g97WS 1 <br /> PHONE(1):��)9'yG '^lnOte PHONE(2); FACSIMILE;2c0-7` '/�07t"IIfB" <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> ow 10 business days fr m date of application submittal-'TentaDYe only-must be confirmed) <br /> EKBOX)T :xPEDl <br /> TE REQUE $B�I:DO EE( OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> NPPLICANT � DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS _.. EHD USE ONLY <br /> Street# Street Name city ❑ Una l <br /> 2 33 Netib-/'nL venni., S4. <br /> 2. .. N 0. i NO co/5� ❑ Unit 2 <br /> U s. S'iock+o UtKli3`^i <br /> 4. <br /> it <br /> �21 q --_ _ <br /> s. # + and need lir —M-11 I n IN unRd <br /> 6. <br /> 7. _. _.. ❑ Unit 5 <br /> 8. <br /> 9, L Unit 6 <br /> 10. <br /> Specific Date Range Of Information Requested: From f <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES V <br /> foHUHAIiARDOUS <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT d SOLID WASTE FACILITYNEHICLE <br /> ER CLEANUP SITE(NON-LOP) C1 FOOD FACILITY ❑WASTE TIRE <br /> ERGROUNDTANK(MONITORING/REMOVAL) In DOG KENNEL ❑DAIRY <br /> WASTE GENERATOR CSC Q CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 11 TIERED PERMITTED FACILITY ❑MOTELIHOTEL M PUMPER TRUCKNARDICHEM TOILETS <br /> ❑TATTOOIBODY PIERCING O POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY C3 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONoAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464.0148 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 prier to review. <br /> EHD USE ONLY <br /> II 4/0 • t I n < <br /> EHD 48-0A WEB Bwor, <br />