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SAN JOAQUIN COUN'T'Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT O <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202.2708 <br /> UC-L N05 Telephone: (209)468-3420 Fax: (209)464-0138 VVeb: www.sjgov.org/eh <br /> ENVIRONNIENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> ApAiid'AN : co e Gleason euslNessrAGENCY: D)ownev Brand LLP <br /> ADDRESS:_ 555 Capitol Mall Blvd. CITY Sacramento srATE Ca <br /> PHONE(1): 916-444-1000 PHONE(2): FACSIMILB916-444-2100 <br /> TENTATIVE*APPOINTMENT DATC:1 2/09/05 Time: <br /> (Please allow 10 business days f om date of apPllca-lon submittal-'Teotaftve only-must be confirmed) <br /> ❑ CHECK BOK TO EXPEDITE fEOuEST•L93.00 EEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 USIINtESS DAYS <br /> SIGNATURE or APPLICAN �^ S>�l' DATE <br /> Li <br /> fie°tro(IiC E3 m d Ma D cri <br /> _in <br /> natlP-. 05 _ pNor <br /> FILE ADDRESS EHD USE ONLY <br /> street r Street Name City <br /> 1le EQad Stockton U P4LC7 Unit 1 <br /> z. <br /> 4. ❑ nit2 <br /> 5• nit 3 <br /> 6. <br /> 7, c; Anif 4 <br /> HE 6. <br /> s ❑ Unit 5 <br /> 10. ❑ Unit 6 <br /> Specific DateRangeof Information Requested:From nn_rlatP rpstrirfinn to `Please call with any questions <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> V UNDERGROUND,TANK(UST):CLEANUP:SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITYNEHmtE <br /> EJOTHERCLEANUPSA'E(NO LOP) ' ❑FOOD FACIUIY EIwAsTE'nR <br /> Ia UNPERGROUND TANK(MORMORINGIREUOVAL) C] DOG KENNEL- ❑.DAIRY <br /> 0 HAZARDOUS WASTE OENERATOR Q CHICKEN RANCR O WASTEWATER TREATMENT PLANT <br /> M TIERED PERMRTEn FAcIUTY ❑MOTEL)HOTEL 0PUMPER TRUCKIYARDICHEMICALTOILETS <br /> TATT60180bY PIERCING ❑POOUSPA 0 LAND USE APPLICATION SRES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASEE SPtCIFY) <br /> WELL ARO.SEPTIC PERRiT RECORDS ARE AVAILARLE FOR REVIEW -MONDAY-FRIPAY a:00 AMS:DDPM - E](CLUOINO HOLIDAYS: <br /> 1, List up to ten addresses In the space above. Select the type(s)of flies from the,list above by checklog the <br /> appropriate hox(es). At least one file type MUST be selected, Fax to(209)464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted—for additiona(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 confirmed <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 eubmitted When the file Is available. <br /> 4. Any file not retumed in the same condition as released will be reorganized by EHD staff atlhe,expense of the <br /> applicant. Future file reviews by the"same applicant may require a$93.00 deposit prior to review. <br /> QIP N-Oi <br /> t0/]11i006 <br />