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I 12/07/2006 14:09 2133800505 ENVIRONMENTAL �; PAGE 01101 <br /> U�JFDD <br /> SAN JOAQUU1 Couyff EHo I,OG Nun�sE R <br /> DEC 0 7 2006 <br /> ENVMONMNTAL HEALTH J)EPAR MEET <br /> r 304 East Weber Avenue,3`�wool', Stockton;CA 95202-2708 <br /> ENVIRONMENT TICESHEALTH Telephone:(209)468-3420 Fax:(209)464-0138 Web: .sjgov.org/ehd <br /> PERMIT/SERVICES <br /> r <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> f APPLICANT: X"MOS1,65 BUSINESSIACENCY: <br /> ADDRESS: W1k.S44,azeGf D <br /> PHONE{i}: 43"""$0-Q551i-- PHUNE(S): ►•" ,_FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: '1 Tf1t1e: <br /> E (Please allow 10 business date o Iication submittal-'T6I:aVv0 only-must be confirmed) <br /> CHECK BOX TO EXPEDITE R UE -S . 0 E(0 , <br /> CHECK ONLY)-REQUEST PROCESSED IN S BUS'" DAYS <br /> f <br /> SIGNATURE OF APPLICANT �I ' DATE I� p <br /> EJOCtrOnIC Information: ❑List❑Map-Description: <br /> FILE ADDRESS EMD USE ONLY <br /> street Street N1altla � - Qky 3 ❑ Unit t' <br /> Z. __._. Unit Z <br /> ...�. . .. Unita <br /> 7. <br /> $. ❑ unit 5 <br /> 70. _ - ❑ unit <br /> Specific Date Range of Information_ Requested:From " to , <br /> ,.! ENVIRONMENTAL HEALTH DEPARTMENT FILES ' <br /> S+.UNDERGROUND TANK(UST)CLEANUP Sire(IAP) Q HOUSING ABATEMENT 13 So 60 WASTE FAC[LrrrlVEH[CLE <br /> ,OTHER CLEANUP 917E(NON4.013j Cl FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(1A0NIT0RINWRFM0VAQ 13 DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PFJiNInTED FACILITY I7.MOTt. HOTEL �' 0 PUMPER TRUCKIYARDICHEM ToiLET's - <br /> ❑TATTooMODY PIERciNA ❑POOUSPA 17 LAND USE APPLICATION SITES <br /> ❑IMIEoicAL WASTE FActLrry ❑OTHER(PLEA9ESPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REV 1Ew- MONDAY-FRIDAY B:Oo AM-5:DDPM - EXCLUDING HOUDAYS, <br /> 1. LJst up to tan dddrasoes in the apace above. Select the typs(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MIST be selected. 2q9 464-0138 or mal Ig hLj§Aress indicated above, Address <br /> ranges will not be accepted-for additional assistance with fila addresses,contact the EHD.Applications received after <br /> 3.00 pm will be processed the next business day. i <br /> 2. The RHD will notify the applicant N any END flies exist An appointment for review wlll'lbe confirmed approximately ten(10) <br /> days after recelpt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. ; <br /> F <br /> 3. A tile that is actively being worked on by EHD staff may not be Immediately available far 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 Gama applicant may require a$95.00 deposit prior to review. <br /> 1=FID USE ONLY <br />�� TE <br /> EHO 48-08 9719gDpg <br />