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MRR. 10.2005 10: 59RM RPF-, ENVIROTECH, INC. NO.289 P.1 l <br />DATE RECEIVEo EHD LUG NUM9ER <br />jj SAN JOAQUM COUNTY . <br />tU EWMONMENTA.L HEALTH DEPARTMENT <br />304.East Weber Avenue, 3d Floor, Stockton, OA 95202-2708: ! <br />LIAR l 0 2005 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd1 <br />Ft ViliOPdMNT HEALTH ]PUBLIC RECORDS RELEASE A PPLICA'IION <br />1FRVAAT" �+T`�4J VO`ti +� SUSINESSIAGENCY: <br />ADDRESS: 'L' UCt73- <br />I� PHONE (1): (-71%1- PHONE (2): 7roT LYS w C]%Q 4}' FACSiLAILE: <br />TENTATIVE" APPOINTMENT DATE: ��`� �� . �� � Time: <br />(Please allow 10 business days from data of applleation submittal - •Tenfaflve only - must be confirmed) <br />Et <br />❑ CHECK ROX TO EXPEDITE REQU EST, $93.00 FEE (CASH OR CHECK ONLY) - RE'=EST PROC ESSED IN 3 9 USINESS DAYS <br />,SIGNATURE OF APPLICANT e DATE 4 <br />3 tt10 r <br />UNIT DISTRISUTION <br />In Unit 1 ❑ UM 2 Q UnR 3 <br />Unit 4 Unit 5 <br />0 Unit b ❑ other (aloctronic;q s=/maps) <br />Streot # <br />FILE ADDRESS <br />Strut Name <br />City - <br />EHD USE ONY <br />1.' <br />`/ _'�x-ih .�.�-;)7 <br />3. <br />�- <br />54�L�c..E/t� <br />4. <br />1, 1 Y`�fca� •% <br />li V 1T1 <br />�er3i ` <br />q <br />I r` ��fiF ♦ <br />11� <br />}s� fz:cJ <br />~� ~� l / 1 1 <br />7. <br />Z44 F5 <br />S. <br />�a5' <br />o.�.• .s <br />5iFlit' <br />'i&paaiFic Date Range of Information Requestad: From t to <br />ENVIRDNMENTAL HEALTH DEPARTMENT FILES <br />,IWUNDERGROUNO TANK (UST) CLEANUP SITE (LOP) M HOUSING ABATEPIENT is SopD WASTE FACRMNEHiCLF <br />41 E3 OTHER CLgANUP SITE! (NON -LOP) 13 FOOD FAci ITY i7 WASTE TIRE' <br />C3 UNDERGROUND TANK(MON;TORIN6/RsMOYAL) t� DOGK"M ' E3 DAIRY <br />❑ HAZARDOUS WASTE GENEIkATOR M CHICKEN RANCH Q WA$TfwATER TREATmcw PLAN - <br />Cl TIERED PERMITTEo FACILITY M MOTFUH0TEL Q pUtdPERTR17Ci(IYARAICHEh1 TOREtS <br />I'M TATTaoli3ooY Pl1♦RCING L3 PQQLfSPA l.A[fD USE AFPUCATIOh $1TEs <br />C2 MEDICAL WASTE FACILITY M 0THFR {PLWF_$PECI(Y) <br />WELL AND SEPTIC PERMIT RECORDS ARE AYAILABLE FOR ReAEw - MONDAY-FRIDAY11, A?A'S :00F - EXCLUDING H6LJDAYS. <br />€ 1, List up to ten addresses in the space above. Select the type(s) of files from the IM above by checking the <br />I appropriate box(as). At least one file type MUST be selected. Fax to 2.09 4lW0138 or mail to the address <br />indicated above. Address ranges will not be accepted —for additional assistance With flle addresses, contaci <br />the EHD. Applications received after 3.00 pm will be processed the next business day. <br />2. The F_HD will notify the applicant if any rcHD files exist. An appointment for review will be eanfrmed <br />approximately ten (10) days after receipt of application. The files will be held for a.rnax "urn of five business <br />days for review. Appointments should be.scheduled accordingly. . <br />,3. A file that is actively being worked on by EH13 staff may not be immediately available for review, A now <br />I? application may be submitted when the flie 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 <br />r applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />3/xr <br />