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SAN JOAQUIN COUNTY ' F <br /> Es'��ONMENTAL HEALTH DEPART '-4 <br /> u u 5 «' 'East Main St. Stockton, CA 9,15)20, <br /> D� l <br /> e�ephone,. (209) 468-3420 Fax: (209) 464-0138 We �w.sjgov-org/ehd/� <br /> [F ,SlrZEP'!1i('-S PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: . 1 {� !J BUSINESSIAGENCY. �L C t M <br /> ADDRESS: I '\'_1J S4e.2Cf) CITYISTATEIZIP: C65f� 1kje50,, C-RolZCcZ <br /> PHONE(1): CJ �— (P - PHONE(2):SiO-CDgS-(oZ�p '_ FACSIMILE: S10`Z95- 2(05 <br /> TENTATIVE*APPOINTMENT DATE: I--Y1a0. p `J . , Z b 10 Time: f�yyt <br /> (Please allow 10 business days from date of app ca'on submittal *Teetaave only-must be confined) <br /> HECK BOX TO EXPED=T $115SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUST LESS DPIYS <br /> SIGNATURE OF APPLICA DATE (0 <br /> Electronic Information: (�List Map- scription: i(b ✓N L)r\ W <br /> FILE ADDRESS C e 4ffqfteA ftf4ftEHD USE ONL <br /> Street# Street Name city, ,,. ❑Unit 1 <br /> 3.1: 20 i c5tk St. vi �3 <br /> 2- L<] uS St "1 Unit 2 <br /> 2 r <br /> 4. J ` �I `^"`✓`� "3 Unita <br /> s. 337- i , I'��� '[[! <br /> 6. ZZ3 W a � -'h)n S _:5-D ' ,. u RA <br /> 7. <br /> + <br /> 8. ) 02_2, �)�� 11 e ! ❑Unit 5 <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From Ll i C' to <br /> pp� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> tfUNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT MSOUD WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY- WASTE TIRE <br /> IXUNDERGROUN[)TANK(MONITORINGIREMOVAL) - ❑DOG KENNEL ❑DAIRY <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN u RANCH )RWASTEWATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATToOIBODY PIERCING - •❑POOLI5PA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY - ❑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)4640138 or mail 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 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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> END DSE ONLY <br /> EHD 48-08 <br /> 8127109 <br />