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DATE RECEIVED <br /> SAN JOAQU N EHI�LoU rlun�BER <br /> _ ,-;r__;�, I. COUNTY <br /> i111f� 'Ir l �'' ENVIk'*NMENTA_L H.EALTI1 DEP ,,N�jj <br /> ARTMEN'I' <br /> 600 East Main Street, Stockton, CA 95202-2708 <br /> -L 5 0 2008 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/e <br /> 4 7 03 <br /> l_,i PUBLI�__,RECORDS RELEASE APPLICATION <br /> APPLICANT: BUS[NESSIAGENCY; <br /> ADDRESS: LK <br /> PHONE(1): c J 922- PHONE(2): Q:�� _ FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> © CHECK BOX TO EXPEDITE RE E(CASH OR CK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APP LICA� BATE J 6 <br /> r <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name CityUnit 1 <br /> 1. lAly - 0r <br /> 2. <br /> ❑ Unit 2 <br /> 3. <br /> 4. F a <br /> ��� y <br /> 5. <br /> 6. ;. <br /> 7. <br /> ❑ Unit 5 <br /> 8. <br /> 9. <br /> -- <br /> 10. El unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT M SOLID WASTE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) OOD FACILITY 17 WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) EI DOG KENNEL M DAIRY <br /> HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH E7 WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL 17) PUMPFR TRUCKIYARDICHEM TOILETS <br /> Q TATTOOIBODY PIERCING C1 POOL/SPA LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 17 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:00pM - ExCLUDING,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 /> 3:04 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> *** If you should need further assistance please contact Diane Martinez e (209)468-3425 directly. Thank You*** <br /> 6HO48-a6 9002006 <br />