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DATE RECEIVED — sno�oawo�asn <br /> SAN KOAQU|N ����K�;J <br /> ��N�y|��K�0����l���� U�E�����f U�������l[88���l� <br /> ~- ^ ~ ~~ � N <br /> Stockton, CA 95205-6232 <br /> East Hazelton Avenue, <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <1 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer B«teIbo BUSINESS/AGENCY: ENGEO Inc <br /> ADDRESS: 580 N. Wilma, Ste. 2l CITY/STATE/ZIP: Ripon, CA 95366 <br /> pHQNE(1): 925-525-4421 pHQNE (2): 925-866-9000 FACSIMILE: 888-279-2698 <br /> ' <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHEC, u�O DAYS <br /> DATE <br /> SIdNATURE OF APPLICANT <br /> Electronic Information: E] List[I Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street# Street Name h City El unit I <br /> 2, 2426 S. Main Street L j-'_t%anteca. El Unit 2 <br /> 3. 2438. 1 S. Main StreeAj Manteca V <br /> 4. 2450 S. Main Street Manteca _[3--rJnit 3 <br /> ------------- <br /> 7. <br /> 8. /U, "i 'All 0 <br /> E]Unit 5 <br /> 9. <br /> El Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> FXJ UNDERGROUND TANK(UST)CLEANUP SITE(L0P) MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEICLI <br /> OTHER CL�mopSITE(Nom'L0P) H000moAo�rsmswr VW�rsllne 1 �1k� /�/u«//,—^ <br /> UNDERGROUND TANK(Mom/ron/wn/RsMuxxLl^ FOOD FAc|ury DAIRY <br /> )�I-�� / �� <br /> ABOVEGROUND TANK - CHICKEN RANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WAors/HxzunoousMxrcmxLo1,11` E]MnrsUHorcL PUMPER TnuuxIY^mo/Cosm|cALTOILETS <br /> TIERED PERMITTED Fxo/ur/,( Puod8px L]LAND USE APPLICATION SITES <br /> F]TAnoo/800YPIERCING []COMPLAINT/RESPONSE RECORDS LJOTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:00pm (EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in theu Select thtype(s)ofn| from the list above by hki the ppr p,i to <br /> box(es). xuleast one file type MUST ueselected. *oo,nos <br /> ranges will not be accepted-for additional assistance with file addresses,contact txcsHo. Applications received after <br /> n:nopmwill uoprocessed the next business day. <br /> z. The s*owill notify the applicant nany snofiles exist. Anappointment for review will ucconfirmed approximately ten(1o) <br /> days after receipt orapplication. The files will boheld for amaximum o,five business days for review. Appointments <br /> should oescheduled 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|savailable. <br /> *. Any file not returned in the same condition as released will be reorganized by EHD staff at the expenseof the Ooant <br /> Future file reviews by x applicant may require $1zsdeposit prior to review. E-�p�lj EHD USE.ONLY <br />