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w nui-21-07 14:10 From-BROWN AND--"'DWELL 91S 635 6805 ; T-632 P.002/002 F-961 <br /> EHD LOG NUMBER <br /> I7 V D SAN JOAQUIN"COUNTY <br /> ENVIRONMENTAL REALTIi DEPARTME } <br /> A(JG 2 1 2007 600 East Main Street, Stockton,"CA 95202-3029 <br /> E{�VI=P�P1 ,El's HEALTHTelephone: (209)468-3420 Fax: (209)464-0138 Web: www-sjgov. <br /> PPP �IT/SP�RVIGES PUBLIC RECORDS RELEASL APPLICA'T'ION <br /> APPLICANT: <br /> BUSINESSIAGENGY: wfj+ 0ALVWeV__ <br /> AvoRi ss: 106 o kjN_ �e X— <br /> PHONE(i): 4 � S41 PHONE(2):!1�td Z 1���y I _4— __FACSIMILE: <br /> TENTATIVE`APPOINTMENT DATE: `f' Tme: I b <br /> (Please allow 10 business days from date of a*Iigatjlin submittal--7antatire only-must be confirmed) <br /> © CHECK SOX TO EXPEDITER QUEST-$08.00 F E:(CASH OR CHECK ONLY)-REOUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN a DATE <br /> Electronic Information: [] LISt❑ Map—Description: <br /> FILE ADDRESS EMD USE ONLY <br /> Street-V_ Streat Name i city ❑'Unit 1 <br /> F22. Unit 2 <br /> 3. - <br /> Unit 3 <br /> 4. <br /> puna <br /> T• ❑ Unit 5 <br /> 9. ❑ Unit s <br /> 10. <br /> Specific Date Range of information Requested:From to q 1 <br /> f <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ZrUNDERGROUND TANK(US-t)CLEANVP SITE(LOP) I=HousING ABATEMENT 0 SOLID WASTE FACILITYNEmni.r <br /> 010T}IER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY M WASTE TIRE <br /> '4217IINDEAGROUND TANK(MONITOFUNGIREMOVAL) M DAG KENNEL 13 DAIRY - <br /> a HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> Q TIERED PEWI TED FACRfIY d MOTELIHOTEL 0 PUMPERTr2UCK1YARDICHEM TOILETS <br /> ❑TATTDOIBODY PIERCING 0 POOLISPA M LANs USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY d OTHER(PLEASE SPECirY) <br /> WELL AND SEPTfG PERMrr RECORDS ARE AVAILABLE FOR RFMEW - MONDAY-FRIDAY$=00 AM.$:00PM -FXCLUDING HOLIDAYS. <br /> t. List up to ten'addresses In the space above." Select the typo(s)of flies from the list above by checking the appropriate" <br /> box(es). At least one file type MUST be selected. Fax to 2D9 4) bet-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted—for addition!l 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 recslpt 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 Weis available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at expense of the applicant. <br /> Future"file reviews by the some applicant may require.al$96.00 deposit prior to review. <br /> EHD USE ONLY <br /> EFED49-0E WEB WWW7 - <br />