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04/16/2009 06:34 FAX 209 473 0469 JOHN RISHWAIN 11001 <br /> EHD LOG NUMBER <br /> DATE RECEIVED1W1' SAN JOAQUI:N COUNTY <br /> RE CCO �l ED� ENVIRONMENTAL WAL.TII DEPAR'rMENT <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> APR 1 6 2009Telephone: (209)469$ 3420 Fax: (209)464-0138 Web: www.si ovq1111'fZ'?6 <br /> ENVIRONMENT HEALTH PITI3LIC RECORDS RELEASE APPLICATION <br /> APPLICANT I (4,4 It Gf uJ'ct.W _� _._ }.f� BUSINESSIAGENCY:_ <br /> ADDRESS X4 1 -7 !x..>c.a G2. C`_j:ul' � I(el ISTA't�IZIP q� <br /> l—. <br /> PHONE(1): ,Z+�`T r.f-I .-.. 75 -'3 PHONE(2): FACSIMILE: ' . yF Ca�L.S.�� <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> Time: <br /> (Please allow 10 business days from date of application submittal•"Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$105.00 FEE(C/ASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTDATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY _ <br /> _ <br /> Street Name City <br /> �Unit 1 <br /> Streetf (p 7 I C t <br /> 2 (�j units <br /> 3. <br /> Unit 3 <br /> 5. <br /> (4!14 <br /> 6. <br /> 7' unit 5 <br /> g <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> C3,UNDERGROUND TANK(UST)CLEANUP SITE(LOP) , !4 OUSING ARAMMCNT _laSOLID WASTE FAC11.11'YIVEHICLE <br /> ,,,LfyyyOTHER CLEANUP SITE(NON-LOP) "M FOOD FACILITY .0`WAsTr.TIRE <br /> ZUNDERGROUND TANK(MOMTORINGIREMOVAL) 15 <br /> oG KENNEL �.M DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH 'WASTEWATER TREATMENT PLANT <br /> �I ERED PERMITTED FACILITY S3'MOTELIHOTEL .r]PUMPER TRUCKNARDICHEM TOILETS <br /> PITATTOOIBODY PIERCING "d POOL/SPA C4 LAND USE APPLICATION SITES <br /> 'r/A EDICAL WASTE FACILITY �P 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 uo 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 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 he reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the salve applicant may require a$105.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***If You need further assistance please contact Diane Martinez IP (209)168 3425 directly. Thank You*** <br /> ...__- <br /> - MHI2MIP <br />