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09/25/2007 08:51 FAX 5307585P-" FEDEX KINKO'S DAUIS 1� 002i003 EHD LOG NUMBER DATE RECEIVED SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.Sjgov.o hd q13 i� PUBLIC RECORDS RELEASE APPLICATION APPLICANT: 1�°� �niS We�tGv f` BUSINESSIAGENCY: ADDRESS: c J e-o AUL`- ('-/4 PHONE (_45 30) 758-S��3 PHONE(2): 730 902_0&3_ZFACSIMILE: TENTATIVE'APPOINTMENT DATE: Time: (Please allow 10 business days from date of application submittal-`Tentative only-must be confi CHECK BOX TO EXPEDITER QUEST-598.00 FEE(CAS HECK ONLY)-REQUEST PROCESSED IN 3 A NATURE OF APPLICANT DATE QZ .a Electronic Information: ❑ List❑ Map-Description: FILE ADDRESS EHD USE ONLY Street 0 Street Name City El Unit 1 1. 70 f m l-o d i 10/ LOd i ND Unit2 2. a N �� T32S�o6 1-od i per' �, pit O ❑ Unit 3 W. Say emsoeo�Com:t�/W S n c.r-,—e't- 4-c' 9 C�a(.�. ..�rT L] Unit 4 L A2:r 5+2Vns 12d LOCL'✓ jo 6' -D �v ❑ Unit s f i Rc>� sd_ f f w f [�G t r uP 98-aq 98 0�,92�2z,9i-ion of-sr�, 9• 2-J� �-D W1E'�c�f•GYG�m K.-j- 9 L.Od i h75'9�_/ ❑ unit6 -I 1o/9 1.o d,* `n6 1 91-0 9 A Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES AA UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACI []FOOD FA ILITY M WASTE TIRE r , OTHER CLEANUP SITE(NON-LOP) ❑DAIRY 1 ❑UNDERGROUND TANK(MONITORING/REMOVAL) K EL HAZARDOUS WASTE GENERATOR NCH ❑WASTEWATER TREA ENT /ANT TIERED PERMITTED FACILITY L ❑PUMPER TRUCKIYARDICHEM TOILETS 13❑TATTOOtBODY PIERCING PA )J.-AND USE APPLICATION SITES Q MEDICAL WASTE FACILITY THER(PLEASE SPECIFY) WELL AND SEPTIC PERMIT O A AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 Am -S:OOPM - EXCLUDING HOLIDAYS. 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact the EHD.Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) - -- dayat affer ret elptof application.--TSF-files Will be field#or ainaximum of five business days for review. Appointments should be r.theduieli 1s-nrdln9IY -.. - 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new app Ica onmay6 — submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant Future file reviews by the same applicant may require a$98.00 deposit prior to review. EHD USE ONLY — EHo se.oe wEs ele�zoo�