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Mar 03 08 11 :48a Apex- 209 6r7-9668 1 <br /> DA R� C IVED �I � 1 II A EHD I OG NUMBER <br /> SAN JO AQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT � 3 <br /> 600 Last Main Street, Stockton; CA 95202-2703 �J <br /> TrtlephmDe: (209) 468-34.20 Fax (209) 464-0138 Web : w�c•w-sjgov.orgiehd <br /> Ia, l�`il - r' - <br /> PUBLIC RECORDS RELEASE APPLICATION(� <br /> APPLICANT: W QtW\ ` t^ BUSINESSIAGENCY: _ <br /> ADDRESS: 344 (= A4 60111 J <br /> wA S! %� pld. 'I' c. Tu At kk. 4 45382, <br /> PHONE (1Y. 209 To(OT ft 0163 t PHONE (2): W1 (a�4 'a "• 27'Si L FACSIMILE: 2P9 6 (07 ' 9668 <br /> TENTATIVE* APPOINTMENT DATE: ti dej Time: O?CO <br /> (Please allow 10 business days from date of application submittal - 'Tentative only - must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST - s98.ot0FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 6 SINESS DAYS <br /> SIGNATURE OF APPLICANT f)/fL�VVt DATE 3 Os <br /> Electronic Information : ❑ List ❑ Map - Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 9 Street Name City ❑ Unit 1 <br /> t . �-1R Eusl- GIAar4v (.1c. S-4ccK �� <br /> 2 . <br /> ❑ Unit 2 <br /> 3. — C <br /> 4, EIunit 3 <br /> I <br /> 5. <br /> 6 Unit 4 �II ' <br /> 7, <br /> 8 <br /> El Unit 5 <br /> 9. <br /> ❑ Unit6 <br /> t 0, 11 <br /> Specific Date Range of Information Requested: From 44 <br /> , to <br /> C , ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> T J29. UNDERGROUND TANK (LST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITYIVEHICLE ' <br /> L1 OTHER CLEANUP SrrE (NON-LOP) —�-�❑ FOOD FACILITY '' ❑-WASTE TIRE <br /> UNDERGROUND TANK (MONITORING/REMOVAL) // � U DOG KENNEL Z ❑ DAIRY <br /> 13 HAZARDOUS WASTE GENERATOR V0 ❑ CHICKEN RANCH Z.¢ - ❑ WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 5 � MOTEUHOTEL POMPERTRUCKIYARD(CHEM TOILETS <br /> ❑ TATTOOIBODYPIERCING ���-P-OOLISPA Z 11 LAND USE APPLICATION SITES <br /> 13MEDICALWASTE FACILITY DTR ]R (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 11:00 AM-5:00Prd - EXCLUDWG 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 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 notifythe 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. Anew application maybe <br /> submitted when the file Is available. <br /> 4. Anyffie 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 /> EHD USE ONLY i <br /> *** If you should need further assistance please contact Diane Martinez @ (209)466-3425 directly_ Thank You*"* <br /> EHD d6-OG 9!Ia,2006 <br />