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05/13/2009 12:32 9163 11809 RANEY GEOTECHNIr/m,. PAGE 01/03 <br /> DATE RECEIVED EHD LOG NUMBER <br /> �F SAN JOAQUIN COUNTY <br /> - `'`'' `St1J ENVIRONMENTAL HEALTH DEPARTMENT <br /> r \� 600 East Main Street, Stockton, CA 95202-3029 <br /> QLg Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www,sjgov.org/e <br /> T �A .AOK PUBLIC RECORDS RELEASE APPLICATION Page 1 Of 3 <br /> etf Showalter Rana GeoCechnical, Inc. <br /> BUSINESSlAGENCY; X <br /> ADDRESS: 3.].40 Beacon Blvd city/statelzip West Sacramento CA 95691 <br /> PHONE(1): 916-371-0434 PHONE(2): FACSIMILE: 9.16-371-1809 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> {Please allow 10 business days from date of application submittal-`Tentative only-must be confirmed) <br /> ID CHECK BOX TO EXPEDITE UEST-$105 F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU INES DAYS <br /> SIGNATURE OF APPLICANT DATE02 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> _ Street# Street Name City <br /> ❑ Unit 1 <br /> 1. 310 S. American St Stockton <br /> 2. 300 S. California St // p C1 Unit2 <br /> s. 325 S. Stanxslaus St // <br /> 4. 327 (, / 1 t3 <br /> 5. 343 T 11 11 <br /> -_ nit 4 <br /> 6. X13 �) <br /> 7. 419 (( Il <br /> 427 ❑ Unit <br /> 8. J1 / <br /> g 433 ElUnits <br /> 9 <br /> 10. 43 f � j <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 FACILITY/VEHICLF <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACII,ITY CI WASTE TIRE <br /> UNDFRGROUND TANK(MONITORINWREMOVAL) ❑DOG KENNEL !7 DAIRY <br /> AHAZAROOVS WASTE GENERATOR Cl CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> 171 TIERED PERMITTED FACILITY ❑MOTFLIHOTEL PUMPER TRUCK/YARD/CHEM TOILETS <br /> 17 TATTOO/BODY PIERCING ©POOL/SPA ID LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WPLL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:00P&I - EXCI,UDING 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 addltional 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 48.06 9104/08 PUBLIC RECORDS RELEASE APP FORM <br />