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DA.IUN. 24. 2009 5:41PM MOFO-FAX CTR X7522 <br /> NN0. 7622 Ep. 2/2NUM8ER <br /> — AN �c)AQUIN COUNTY <br /> „'_ ;i'`',f I__,`.�' ENVIRONMENTAL HEALTH DrzPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> i`,, 5 ZOr'` Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: WwW,Sjgov.or <br /> -j\ 7 I_! PUBLIC RECORDS RELEASE APPLICATION <br /> in.�- J1l1 .. ' <br /> A PLycAN'�:``Mark W. Poe BUSINESS/AGENCY; MO-rriSOn & Foerster LLP <br /> ADDRESS: - 425 Market -Itreet, 32nd Floor City/State/Zip San firancisco CA 4105-2482 <br /> PHONE(1): 415. 268 .7000 PHONE(2): FACSIMILE: 415 . 268. 7522 <br /> TENTATIVE*APPOINTMENT DATE: 0,7/09/0910:00 a.m. <br /> Time; <br /> (Please allow 10 business days from date of apPllcation submittal--Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT DATE ��y�ra _ <br /> Electronic Information,- ❑ List Map—Description: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street Name - - <br /> _ __ City - <br /> 1. 800 West Church Street Stockton ❑ Unit <br /> 2. <br /> _ O unit z <br /> 3. <br /> 4. -- - <br /> -6 - , .... — - •-- - - -- ,.... --- -- Unit 4 <br /> 7 - _.. <br /> -- - ---- <br /> 8. ---- - -- ---- nif 5 <br /> 10. - ❑ Unit 6 <br /> Specific Date Range of Information Requested: From to01101119-89 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> N UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE <br /> M OTHER CLEANUP SITE(NON-LOP) 11 FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL D DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> C1 TIERED PERMITTED FACILITY 0 MOTEUHOTEL PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITE$ <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:OOPM - EXCLUDING Ho410AYS. <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209 4,54-0138 or mail to the @ddress indi ated 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 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 roview. 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$105 deposit prior to review. <br /> EHD USE ONLY , <br /> EHD 48.06 8104/08 PUBLIC RECORDS RELEASE APP FORM <br />