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05/10/2008 09:54 916446''-q3 MATT PAGE 01 <br /> DATER CEIVED EHD LOG NUMBER <br /> SAN .1C7AQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> J' <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/e d <br /> PUBLIC RECORDS RELEASE APPLICATION -008 <br /> Ali <br /> APPLICANT: Lig—jr BUSINESS/AGENCY: DEL- NEAP!T� <br /> ADDRESS: 71-It (,114-( _YU 1 J IZ4'ic"11-7 C-,l 1C'ES <br /> PHONE(1): 1'l G _9_j+,& ._r}}iY0 PHONE(2). FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: 57`2_q~0th <br /> (Please allow ten business days from date of application submittal-*Tentative only-must ba confirmed}- <br /> © CHECK BOX TO EXPEDITE REQUEST-$9 00 FEE ASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT `7' DATE <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS _ _ EHD USE ONLY <br /> Street# Street Name City C)Unit 1 <br /> W(00-) W 4V 5 _ _ r,A <br /> 22. 1160 YU51�fLT, fiva"uCMgn �C,9 �d�)"�p' <br /> .�•'X <br /> ,., <br /> ❑�.Unit 2 <br /> 3- I 13 cHle R Way 5—(VCkTOrJ qf6 { <br /> QLoo iOnt/ <br /> 9 <br /> PQ1' u5 Unit4 � i�V <br /> 6. <br /> . c <br /> I1142Ul� w�Y �l� �J ?t6N1, (!9 t'qV-111`�0 Unit$ <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested:From to P('2e5Er1; <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> >1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) In FOOD FACILITY Q WASTE TIRE I <br /> UNDERGROUND TANK(MONITORING/REMOVAL) C3 DOG KENNEL 171 DAIRY �,I rtJ" 3 <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH 0 WASTEWATER TREATMENT PL NT <br /> ,RCTIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEM TOILETS ✓�J !Ip <br /> ❑TATTOO/BODY PIERCING 0 POOUSPA ❑LAND USE APPLICATIONITES k <br /> 17 MEDICAL WASTE FACILITY ID OTHER(PLEASE SPECIFY)kVR� � eke 673 iD T I 69F.? PIL40E <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW- MONDAY-FRioAY 8:00 AM-6:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to tan addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3.00 pm will <br /> be processed the next business day. <br /> 2. The EMD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten <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 the EHD staff may not be Immediately available for review. A new application <br /> may be 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$98.00 deposit prior to review. <br /> EHO USE ONLY <br /> l - 6 — W <br /> arm 11-M W291= PUaLIG RECORDS RELEASE APP F(NtM <br />