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APR 1F6,2008 12:22 000-000-00000 page <br /> Fr— 7--,3 <br /> 0411ilc [01 EHL)LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> APP, 1 6 ?.008 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> E1NV1P 0 (209)468-3420 Fax: (209)464-0138 Web; www.Sjgov.o /eh 5k <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT': r BUSINESSIAGENCY: ZCD Lv <br /> ADDRESS: <br /> DDRIESS'. <br /> PHONE(11): t 11 Z3 PHONE(2)' -T&Q. • FACSIMILE: <br /> TENTATIVE*APPOINTMENT nATe; <br /> (Please allow to"business-days from date of)PLPILQn submittal-*1`617ftfive only,-must be continued) <br /> CHECK BOX TO EXPEDITE REquES (CASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BLISI <br /> SIGNATURE OF APPLICANT DAT.C 88 DAYS <br /> Electronic info rriation: Q Llat[D Map-De&uriptlon: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street# Street Nome City r7 unit 1 <br /> ---ALL ced 6t, <br /> 0 unit 2 <br /> A!Q <br /> n1t.3 <br /> S. <br /> z <br /> eUnit 4 <br /> 7. <br /> •4) Unit 6 <br /> 10. E-di'5 Do 5f, <,5tv clCraq Anits <br /> Specific Date Range of Information Requested;From -410o' <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 4UNDERORouND TANK(USTI CLEANUP SITE(LOP) C3 HGusiNa MATEVViT <br /> 0THEA CLEANUP SITE(NON-4,OP) 173 F000 FAvILITy P'i0LjVWAS'ra FACILITVIVEHICLE <br /> ,W WASTE TIRE <br /> 'J!CUNDERGROUND TANK(MONITORINWREMOVAL) 0 DOG-KENNEL EO DAIRY <br /> AZARDOUS WASTE GENERATQF( 13 CHICKEN RANCH C3 WA$rLWATER TREATMENT PLANT <br /> H <br /> TIERED PERMITTED FACILITY 0 MOTE04QTEL 0 PUMPER TRUCK/YARDICHEM TOILFT5 <br /> 0 TAMWOODY PIERCING Cl POOLtSPA 0 LAND V69 APPLICATION SITES <br /> El MEDICAL WASTE FACILITY C3 OTHER(PLEASE SPECIF <br /> WELL AND SEPTIC PERMIT RE0DR6S ARE AVAILABLE FOR REVIEW. MONDAY-FRIDAY 8.00 AM-r2:Gopm. EXCLUDING HOLIDAYS_ <br /> 1. List up to ten addressee in the Space above- $elect the type(g)of flies from The list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Eax to(zaq)4 1 <br /> 64-00 8 Of mallo the a bova_ft4are U. 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 If any EHD flies eXist. An OPPOIntmOnt for review will be Confirmed approximately ten <br /> days after receipt Of application, The files will be held for a maximum of five business days for review. Appointments <br /> should he scheduled accordingly. <br /> 3. A file 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 Some Condition as released will be reorganized by END staff at the expense of the applicant, <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to r*Wew. <br /> EHD USE ONLY <br /> '65-RD— <br /> PUBLIC RE 311EiTAXISEAPP FORM <br />