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reti G 08 09: 45a Marcia Tyree Herbert (8251 -3738 P. 1 <br /> DATE RECEIVED i� EHD LOG NUMBER <br /> �! SAN JOAQUIN COUNTY 94 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 604 East Main Street, Stockton, CA 95202-2708 <br /> 'Telephone: (209)468-3420 Fax: (209)464-0138 Web: ti;nvw.9jgo�,.or <br /> � r <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ! 1�r BUSINESSIAGENCY: VV� <br /> ADDRESS: X15 W. P ne GJ . '5Te . `2 LOd i 5 24 SI 1 <br /> PHONE(1):C22J_ h3b 1C25JPH0NE(z): �cl25�21Z' 551a I FA <br /> CSIMI1LE: <br /> 01�3 <br /> TENTATIVE*APPOINTMENT DATE: . ��b. ( '7_qDl�' Time:—y ' t�'! (of t. . �. <br /> (Please allow 10 business days from dale of application submit(al-'Tentative only-must be confirmed) <br /> %CHECK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS P <br /> t>�ible. <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: Q List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> 1. + Street# Street Name city `,���� ❑ Unit 1 <br /> 130V_ 12 rYliri,4JI, Si+,f, Port D Sac 61-0c1Zto W�-,t docs -ttirlA S ��1�� <br /> 2. �_i 11 W. Wa!ShiY1 �r1 St-. sfio Gk� VS t i ❑ Unit 2 <br /> 3. <br /> 5 2b GU. WG�shir, ion St. SIc- K ar of of :ueUnR3 <br /> ly d� <br /> 4. 2�� � YU��h�,��n SI-. St�z�c.�-,n� 1z � <br /> . 2 52 C Pork Foc�d S }v+� qtr► „It a <br /> Y. - - -- x ❑ unit s <br /> J� C{ 8. -- <br /> �r Unit G <br /> Specific Date Range of Information Requested: From ► to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITWVEHICLE <br /> Z OTHER CLEANUP SITE(NON-LOP) I-) FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL)./ 11 DOG KENNEL 0 DAIRY <br /> JZ HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATERTREATMENTPLANT <br /> TIERED PERM{TTED FACILITY 0 MOTEL/HOTEL El PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOO/BODY PIERCING M POOLISPA ❑ LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:40PM - 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(209)464-0138 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 fife 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 /> *" <br /> if you should need further assistance please contact biane Martinez a (209)465-3425 directly. Thank You*** <br /> EHD 48-06 51142006 <br />