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Apr 10 2000 1 : 35PM E2C, Inc. 14003275707 P. 1 <br /> DATE RECEIVED <br /> EHD LOG NUMBERSAN JOAQUIN COUNTY <br /> 2006 APR 10 p(3 ��jjti: ONMENTAL HEALTH DEPARTMENT <br /> 30�B`as�'t ber Avenue,3`1 Floor, Stockton,CA 95202-2708 Z <br /> Telegho8e �20$)468-3420 Faa:(209)464-0138 Web:vnAtivsjgov.org(ehdENVIROI59.. JU., uII L JP I ✓✓�` VTJ <br /> HE4LLTH DPPURLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: oq'k BUSINESSLAGENCY: r---ZC joc" <br /> ADDRESS: •� a}. <br /> PHONE(1): 3))- ���� PHONE(2): � \\ `,1 FACSIMILE:�2 y_,CY7� <br /> TENTATIVE*APPOINTMENT DATE: lifE, �'�'A Tone: <br /> (Please allow 10 business days from dat of ubmlUal•'Tentative only-must be coMlrmed) <br /> El CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE(CASH OR CHECK ONLY).REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION Cl unit1 0 unit ri unit3 0 Unit4 ❑ Unit5 Cl Unit 0 Other(slectronicnistsllnaps) <br /> FILE ADDRESS EHD USE ONLY, <br /> Stre"111 Street Name city <br /> 1. <br /> 2. <br /> 3. L; ` <br /> 4. <br /> 5. <br /> 5. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> SPeciFic Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES; <br /> NDERGROUND TANK(UST)CLEANUP STE(LOP) ❑HOUSING A13ATEMENT O SOLID WASTE FADLITYNEHICLE <br /> OTHER CLEANUP SITE(NON{OP) 13 FOOD FACILITY IM WASTE TIRE <br /> iW../UNDERGROUND TANK 4MO <br /> ONITORINGIRENOVAL) DOG KENNEL ODAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH C]WASTEWATER TREATMENT PLANT <br /> 13 TIERED PERMnTEDFACILRY 0MIOTEUHOTEL C7 PUMPER TRUCKAYARDICHEM TOILETS <br /> 0 TATTOCVBODY PIERCING 0 POOLiSPA nT��nn 0,.r'�p,�'0 USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY O OTHER(PLEASESPEOFT) fi '4 )ing LAA WELL AND SEPTIC PERMR RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY8:00 AM•5:0OPM • E=LUDNG HOLIDAYS, <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST he selected. Fax to f2091464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the END.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 fifes will be held for a ma)dmum of frse 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 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> -A <br /> EHD,9-QIdOB ---- <br /> ,NNlOa <br />