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AUG-21-2008 THU 01;31 PN C�I�,jERS INTERNATIONAL FAX N0, 2094755102 P. 02 <br /> R c ` ,/IL} 0 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> AUG 2 1 2008 ENVIRONMENTAL HEALTH DEPARTMMain Street, Stockton, CA 95� E3e7 <br /> 29 <br /> ENVIRONPAEN T HEALT�lephone; (2 9)468600 -3420 Fax; (209)464.0138 Web: www <br /> 51 <br /> PERM1T!SERVICES ( ) <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: r1t"„J�y�+ S`CIC.\ }�,(�C,(.�. BUSINESSIAGENCY: ()CJL-.L.t t_''YL� <br /> ADDRESS: SL�gLbc1 R7 ST lc.:aSC City/stato/Zip _5'�OC.K�Tr,9tti1 C4 Q52.I S' <br /> PHONE(t): 9— S7)%kS-"2PHONE(_2): �Z)L.f'\ ^�� 7 FACSIMILE: jSkj)q_1 �,` \�-2— <br /> v <br /> TENTATIVE'APPOINTMENT DATE: }>[ j �{{- <br /> (Please allow 1 D buslnoss days from date o1 appllca lon submittal-"Tentative only-Musa be OOTime, q�e Afinned) <br /> 1-3 CHECK BOX TO EXPEDITE RE ST- 105 FEE( ASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE �S_1.z( qFK <br /> Electronic Inforrnation: ❑List L]Map—Description; <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City <br /> 1. S� vN ❑ Unit <br /> 2. <br /> Unit 2 <br /> 4' Unit 3 �\✓ <br /> 5. <br /> 6. 1n _ �nita <br /> 7. �r� <br /> $, ❑ Units <br /> 9. <br /> 10. w ❑ Unit 6 <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> tNDEROROUND TANK(UST)CLEANUP SITE(LOP) I7 HOUSING ABATEMENT N SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) E3 FOOD FACILITY 12 WASTE TIRE <br /> U <br /> NDERGROUND TANK(MONITORINGIREMOVAL) 17000 KENNEL C3 DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR f7 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTLUHOTEL CI PUMPER TRUCKIYARD/CHEM TOILETS <br /> M TATTOOIBODY PIERCING OPOOUSPq 173 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIf•Y) <br /> WELL AND SEPTIC PERMIT RECORDS ARE.AVAILABLE POR REmcw. MONDAY-FRIDAY 5:00 AM-6:00Pm - EXCLUDING HOLIDAYS. <br /> 1, List up to ton addresses In the space above. Select the typos)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected, Fax fo.12091464.0138 or mall 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 111es exl3t. An appointment for review will be Confirmed approximately ten(10) <br /> days after receipt of application. The 11103 will be hold 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 now application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released WIII 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 /> P E i <br /> EHD 48.06 W04108 <br /> PUSLIC RECORDS RERELEASE APP FORM <br />