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05/13/2008 08:54 FAX 1/001 <br /> DAT ' D EHD L00 NUMBER <br /> V SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT /n*, <br /> mAy 1. 3 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ hdS D <br /> ENViRONMEN H PUBLIC RECORDS RELEASE APPLICATIO <br /> S • iVICES <br /> PER / — <br /> APPLICANT: (YNY'IS SG�d, /r BUSINESSIAGENCY: C-n LOn S&rylefs <br /> ADDRESS: 7J434 M(M✓LOn) /�V`G S-}e C <br /> PHONE(1): 0 G 4 VO 024 h PHONE(2): FACSIMILE: q14 4Ve 0&&3 <br /> TENTATIVE"APPOINTMENT DATE: SI�2f D$ Time; <br /> Uhl <br /> (Ploaso allow tan business days from data of appilOation subminel.•Tanfaf"only-must be wnflr d) <br /> ❑ CHECK BOX TO EXPEDITE REQUU�S^T--S9a. EE(CA OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OFAPPLICANT l�� (� F DATE <br /> Electronic Information: ❑ List[]Map-DeSCriptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Streets Street Name City Ounit I <br /> i IOr6 py}1 VSA+ vrw o Ltc}dn <br /> 2. 3Y5 wzSY gyfK J1f'eelf,0Lk0A F' r OUnit2 <br /> 3. oN rTZrta k at* knIPI <br /> 4- H2LA ' py2 $vrvh iirza S' Iprwrdfi 36 a<, O6'ls Unh9 <br /> 5. yoS rAVY fCa2 7t?dI GLu tFl1 V- F i= <br /> [7. <br /> 405 Lin6dln 5�'_ IU. F, F nd4 <br /> 611 w rurlafnd itif. ' f0 Unit 5 <br /> nit 6 <br /> Specific Date Range of Information Requested:From '4+19 e&fl ICS-Y to VO <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> M UNDERGRouao TANK(UST)CLEANUP SITE(LOP) 0 HDumma ABATEMENT SOLID WASTE FACILITYVEHICLE <br /> [%OTHER CLEANUP SITE(NDN-LOP) 0 FOOD FACILITY WASTE TIRE <br /> Q UNUEROROUND TANK(MONTORINGIREMOVAL) ❑DOG KENNEL Cl DAIRY <br /> nt HA RDDUS WASTE GENERATOR 0 CKICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> CIE TIERan PERMITTED FACILITY 0 MOTELIHOTDL 0 PUMPER TRUCKIYARD/CHEM TOILETS <br /> 0 TATTOOIBODY PIERCING C POOLISPA O LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILrTY 0 OTHER(PLEASE SPFCIPY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FmoAY 9:00 AM-5:00PM - EXCLUDIHO HOLIDAYS. <br /> L List up to tan addresses In the space above. Select the type(&)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(20 )464-0136 or mail tot the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> be processed the next business day. <br /> 2. The EHD will notify the applicant N any EHD flies exist. An appointment for review will be confirmed approximately ten <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A Tile that Is actively being worked on by the EHD staff may not be Immediately available for review. A new application <br /> 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 applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> i:HO U-06 1012MT PumiC RECORDS RELEASE APP FORM <br />