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2006 9:5 2 P M Adl ced G e o E n v i r o n in e n t a I No. 4936 P. 2 <br /> .cCEIVED ,. EHD I.OG NUM55 R <br /> f j fj SAN JOAQUIN COINTY <br /> u v L D ENVIRONMENTAL HEALTH EPARTMENT <br /> - 304 East Weber Avenue,3"d Floor, Stoc cton,CA 95202-2748 <br /> MA� 1 8 2006 Telephone: (209)468-3420 Fax: (209)464-01 8 Web: www.sjgov.org/ehd <br /> EiVVIROIPR HEALTH PUBLIC RECORDS RELEAS. APPLICATION <br /> Z3 P7 Iq <br /> P s <br /> APP '6NT: I USINESSIAG E NCY: V A r <br /> Aoo�ss; b + <br /> PHONE(1): PHONE(2): 0 'I FACSIMILE; 6 7 `f-( <br /> TENTATIVE"APPOINTMENT DATE. rime; 140:00A0%. <br /> (?lease allow 10 business days from date of apps on submit I-"Teatadve only-must be confirmed) <br /> I� CHECK BOX TO EXPEDITE"A E T-$93,00 FEE(C CH K O LY).-REQUEST PROCE§SED IN 3 BUM SS DAYS <br /> SiGiVi4TURE OF APPLICANT <br /> DATE j. <br /> UNIT'DISTRIBUTION ❑ Unit 1 ET Unit 2 M Unit 3 0 Unit ❑ 1 ntt6 ❑ Unlit a R Other(electroniclllsiximaps) <br /> i�. FILE ADDRESS <br /> street 0 Street Nam® Ctky EHD-USE ONLY <br /> �. 'I a , <br /> 3. <br /> 4. 'I U ` <br /> 45. t t1 <br /> B. i� A'• <br /> li N.=r <br /> S, <br /> Speafic Data Range of.lnformatlon Requested:From to )MR <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �UN6ERf3ROUND TANK(UST)CLEANUP SITE(LOP) L]HOUSING ABATEMENT ©SOLID WASTE FAcLE "- <br /> TI1ER CmmuP$ITE(NOWLOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUNDTANK(MONrfORINdRF,moVAL) ❑Doe KENNEL 0 DAIRY <br /> AZARDowswASTE GENERATOR (J CHICKENIRANSrm ❑WAZTEWATER TREATMENT PLART <br /> ❑'n6eo PmR rrma FACILITY ❑MOTEUHOTEL 13 PVMFSR TRUcr YARo1C"gm TGILETS <br /> TAtTO0IB01iY Perna G d POOLMPA AL.AND USE APPLICATION SITES <br /> Q MEAICAL WASTE FACILITY ❑OTHER(PLEASE SPE <br /> WELL AND SEPTIC PERFUr RECORDS ARE AVAILADLE roR REVIEW- MONDA R[PAY 8:00 Am-6;00PM - D.CI.VDmti HoLmAYs. <br /> 1. Llat up to ten addresses ITS the space above. Select the type(s)of flies from the list above by checking tite <br /> appropriate box(es). At least one file type MUST be selected. ax to 209 464-DI38 or mail to the address <br /> Lndleated above. Address ranges will not be accepted—for ad Stional assistance with file addresses,contact <br /> ttio EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An app intinent for review will be confirmed <br /> approklmateiy ten(10)days after receipt of application. The files will be held tar a maximum of five bLLsirera <br /> dbys for review. Appointments should be scheduled accordinj ly. <br /> 3. Afile that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> a47plication may be submitted whorl the file is available. <br /> 4. Airy file not returned In the same condition as released will be-morganized by kHD staff at the expenae of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> r , <br /> 1 <br /> EM 4142-M <br /> in4ros <br />