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DATE RECNF�- EHD LOG NUME3EER <br /> SAN JOAQUIN COUNTY <br /> )ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> .['t ILI rl Telephone; (209)468-3420 Fax: (209)464-0139 Web: w-wvv,sjguv,org/ehY <br /> PUBLIC RECORDS RELEASE "PLICATION t 3? <br /> APPLICANT: fflh-"'1y-'k4 DUSINESSIAGENCY: f (`Mg�j)�7613 <br /> 0 <br /> ADOREUSI�b-0 -PJMdi) lta CIMSTATE/Zipkiattil A,-� <br /> PHONE(1}: (925)7j4(o-(aj25,-3 PHONE oc'v FACSIM ILL: <br /> r <br /> TENTATIVE*A.PpowirmENr PATF-: Time: <br /> (Please allow 10 business days from date of application submittal-I T#n(4t;ye only-must be Confirmed) <br /> CHECK BOX TO EXPECICTE REQUEST.$10 PW,- E(CASH OR CHECK ONLY)-REQUEST PROCESSED 114 3 BUSINESS DAY$ <br /> SIGNATURE OF APPLICAt Tj��:�r DATE 0M01( 1vDD'j <br /> Electronic Information: ❑ List[] Map—Description: <br /> FILE ADDRES$ EHD USE ONLY <br /> Street fi Street Name G!!Y Unit I <br /> 1, tno —SPftCkft-5 AVF M PN T-F C A Z <br /> 2. /runit 2' <br /> 3. <br /> 4. pit 3 <br /> 5. <br /> 6. Unit 4 <br /> 7. <br /> Unit 6 <br /> 10. <br /> unit s <br /> Specific Date Range Of Information Requested:- From 0 01 /;Zoo-7 tv 031 -qn 1 a 9 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSINcABATEMENT FP$UUv WASTE FACILITYIVEHICLE 'Ski <br /> U60THER CLEANUP SITE(NON-LOP) 9FOoo FACILITY PAVASTETIRV <br /> I!FUN[3FRr,ROUNr)TANK(MONITOPUCIREMOVAL) -V DDG KENNEL Rr= <br /> MV-HAZANDOUS WASTE GENERATOR CHICKEN RANCH UWATIER TREATMENt PLAW <br /> t�TIERED PERUTTED FACILITY '7P OTELIHOTEL PUMPER TROCKWARVICHEM TOILE.5 <br /> 'TATTOOISODY NERCINC; t%3 o0LJ51`A PP L4NO USE APPLICATION SITU <br /> OPMEDICAL WASH FACILITY FFOMER(PLEASE SPECWY) 040 fL'4-r-2�" <br /> WELL AND SEPnc PERMIT RECORDS ARE AVAILABLE FOR REVIEW-MONDAY-FRIDAY a:00 Am-5.00pm - EXCLUDING HOLIDAYS. <br /> 1, List up to tan addresses in the space above. Select thutype(s)of files from the list above I by checking the appropriate <br /> box(es). At least one fiI0"MUST be selected ftx to(2091464,0138 or mail to the address Indicated jabove. Address <br /> ranger,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 notIty the applicant If any EHD files exist. An appointment for review will be confirmed approximately ton(10) <br /> days after receipt Of application. The files will be hold for a maximum,of five business;days for review, Appointments <br /> should be ocheduled accordingly. <br /> & A file that 13 actively being worked on by EHD staff may not be Immediately available for review. A now 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 OXPOnSe of the applicant. <br /> Future file reviews by the same applicant may require a$105.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***If you need further assistance please COrlt=t Diane Martinez @ (209)468-3425 directly, Thank You` <br /> EHO <br /> 8164 8 <br /> TO/To 39vd SiNVi-insNoo 13V <br /> '6 LE:zT 600Z/60/60 <br />