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01/--0/2006 09:49 FAX 1 209 234 7727 STOCKTON 1L1002 <br /> 01/10/2006 09:34 46401 ENVIRONMENTALTH PAGE 01 <br /> L'AI t Ntl:t1Vtll r—nu Lvw a4umDCR <br /> SAN JOA,.QUIN COUN'T'Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Veber Avenue, 3"1 Floor, Stockton, CA, 952022708 <br /> 'Zclephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ebd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICI N } BUSINESS(AGENCY: 0,X,ic <br /> ADDRESS: 34 I o W-(�o ww,zr Ls�tnr� �u�i't_F__ CITY � ky� STATE_ CA <br /> PHONE(1): 2-3q-7-7 ZL PHONE(2): FACSIMILE 13LA—7 7 27 <br /> TENTATNE"APPOINTMENT DATE: <br /> (Pleas*allow 10 business days from date of appticaflw submittal-*7enfadi v only-must be con <br /> CHECK SOX TO EXPEDITEsT REQ 3,00 H OR CHECK ONLY)-REQUEST PROCES5FA( B € 1 fl1 <br /> SIGNATURE OF APPLICANT / �J�/C=� 1�- —DATE 1 t o <br /> Electronic E3 Ust 0 Map-Description <br /> Information <br /> FILE ADDRESSEHD USE ONLY <br /> Stye®t# Street Name City <br /> � ❑ �U nit 1 �S <br /> 1, era R' <br /> 2. oo 15• R. Rd <br /> 3. ❑ Unit 2 3P <br /> 4. /"Unit 3 <br /> 5, <br /> s. JeUnit 4 <br /> 7. <br /> s. Unit 5 <br /> 9. . <br /> 10. Unit 6 <br /> Specific Date Range of information Requested:From to <br /> ��yy <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> p UNDEwAouxo TANK(UST)CL.SANUP SITE(LOP) K HOUSING A9ATM9NT SOLID WASTE FA=rlNEHnu <br /> 'ISI OTHER CLEANUP SITE(Non-LOP) C3 FOOD FACILrfY WASTE Twte <br /> ©DOG KENNEL Q DAIRY <br /> ItUNDERGROUNDW TANK(MONnENtRAORLNf�/REMOVAL) 0 CHICKEN RANCH 0 WASTEWA�TREATMENT PLANT <br /> l�.HAZARDOUS WASTE GENERATOR <br /> IiZTIERED PERM1TrenFACiLnY 0 M=Lq: IOTEL 0 pUMPERTRUCKrYAR0jCHE=ALTo1LeT3 <br /> TATTOOMODY PIERCK3 13 POOUSPAQ �� `0 LINO USE APPLICAMN SITES <br /> >t 1NEUICAL WA9TH FACILITY 0 OTIMR(PLP_ASE SPECEY) AK 4i,- . <br /> WELL AND SEPTIC PEWrr RECORDS ARE AVAILABLE FOR RMRW -MONDAY-FRIDAY$:00 -5:0OPM - EXCLUDING HOLIDAYS. <br /> T. list up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted–for additional assistance with file addresses,contact <br /> the 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 appointment for review will be conf)rmEd <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments 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 <br /> application may be submitted when the file is available, <br /> 4. applica t Future file lreviews by the same applicant may require n the same condition as released will be $93io d post priory toff trevi the wpense of the <br /> rKV"-Go <br /> 10/SSI�oa6 <br />