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06/01/2010 09:59 92574E`J9 AEI CONSULTANTS - PAGE 01/01 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY EHo Loc Nu EES <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St, Stockton, CA 95202-3029 <br /> Telephone: (209)466-3420 Fax: (209) 464-0138 Web: www.$jgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: !s' w .. �'�� _ BUSINESS/AGENCY;— S— <br /> ADDRESS: ZSOD CITY/STATEIZIP: 1, ,`,t <br /> PHONE(1): ctZS- 7yb^bo`i5 PHONE(2): FACSIMILE: 9 <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of applloatlon submkta(- Teniattn only-must be conflrmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST4115 FEE(CA$H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street p Street Name city <br /> 0 R-.��bv� �qr� L49 T 8 Unit 1 <br /> 2. -- ,©ES <br /> 3, Unit 2- <br /> 4. Zn TFT(e <br /> 5, nit 3 �C <br /> 6. <br /> 7, R4 <br /> 8. <br /> 9. ❑Unit 5 <br /> Specific Date Range of information Requested: From umt 0 <br /> ENVIRONMENTADEPARTMENT FILES to <br /> L HEALTH <br /> UNDERGROUND TANK(LIST)CLEANUPSITE(LOP) ❑HOUSING A9ATEMENT EOUD WggTE FACILITYNEMCLE 3h� <br /> —�JOTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑ <br /> UNDERGROUND TANK(MONRORIN/G�IREMOVAL WASTE TIRE � j <br /> HAZARDOUS WASTE GENERATOR V' ) [j CHICKEN KENNEL <br /> DAIRY U/)t��' <br /> ❑TIERED PERMITTED FACILITY WASTEWATER TREATMENT PLANT tP/100 <br /> ❑MOTFUHOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑T MEDICAL <br /> WA PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITE$ <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) - <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAJLA94E FOR REVIEW: MONDAY-FRIDAY 0;00 AM-5:00PM(EXCLUDING HOLIDAYS <br /> 7. List un to tem^ddrecces in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected- EU (209)464-0136 or mai to th adtl s 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 conflrmaci 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 Tile that is actively being worked on by EHD staff may not be Immediately avalfabia for review. Anew application maybe <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$115 deposit prior to review, <br /> S. If you need further assistance,please contact Diane Martinez,at(209)46&3425. <br /> EHD U6E ONLY <br /> Ell 4P e6 <br /> arzrms <br />