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Feb 06 08 09: 45a Marda Tyree Herbert (925) 94'7-3738 P. 1 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN ,TOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.or 45 <br /> PUBLIC RECORDS RELEASE APPLICATION ° <br /> APPLICANT: Iv I art a_ H e1—be—r L BUSINESS/AGENCY: <br /> ADDRESS: �1� VV- P t'le Gj�, t �tt? LOd 1� (-A01624D <br /> PHONE(1):(Z0g)3541 h3(0�x253PHONE(2):J9 ZS)ZIZ - 17)11 1 FACSIMILE: (gal ) 75-54 S-7-4 <br /> TENTATIVE"APPOINTMENT DATE: Time: 3� �JtrV (pr <br /> (Please allow 10 business days from date of application submit al-"Tentative only-must be confirmed) g t <br /> CHECK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS po5�'Ible <br /> SIGNATURE OF APPLICANT oI DATE _Z Q 8 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY _ <br /> Street# Street Name city _ ❑ Unit 1 <br /> 1- Porf oc Stat 51-00 I&CY) <br /> 2. a-11-1 W. St. S�ocv_ -D /-Jr Unit2 <br /> 3. 5210 �U- Was�'lirl ton St. S�-0T fW�. ✓ <br /> 4 Unit 3 <br /> ZZo t _ _wash�"for) ef. Stoz l�h�-ver v�o�,x PW <br /> 5• 2 5_21 POrk Roar i F S <br /> _ Unit 4 <br /> 6 <br /> 7. <br /> ❑ Unit 5 <br /> 8. <br /> 9. <br /> Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From �� t�S I" to py-e,6enl­ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> 1 OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTEUHOTEL 0 PUMPER TRUCKNARDICHEM TOILETS <br /> 0 TATTOO/BODY PIERCING 0 POOL/SPA 0 LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING 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 appropriate <br /> box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted—for additiona[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 files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The files will be held 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 new application may be <br /> 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 applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> *** If you should need further assistance please contact biane Martinez @ (209)468-3425 directly. Thank You*** <br /> EHD 48.06 9/142006 <br />