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To:SIX Page 1 of 1 2009-10-13 17:09:54(GMT) 15103720452 From:Tim Loeb <br /> EHE)LOG NUMBER. <br /> SAN JOAQUIN COUNTY <br /> �Il It9 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> h ne: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.orglehhd <br /> (t PUBLtC RECORDS RELEASE APPLICATION l �C <br /> _ — — <br /> ADDRESS: � Zoe 6 - —BUSINESSIAGENCY_ 7Z� L <br /> 1� <br /> t -1 �L:_P�' _ _—_ CITYISTATE/ZIP. <br /> N�N IT <br /> PHONE(1): � S/off '�7 (. Y'*4 f 0 PHONE(2): FACSIMILE. 71, <br /> 0 TENTATIVE APPOINTMENT DATE. Time <br /> i (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> F ❑ <br /> CHI CK BOX TO EXPEOITL REAL ST $1/15/FEE(CASH OR C -CKONI:Y)-REQUEST PROCESSED iN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / 'fjy y-C L•-- L1(� 'r- _ DATEZ�,/lz <br /> Electronic Information: ❑ List❑ Map-Description: <br /> f FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city Ny n <br /> El <br /> i <br /> �3`t5 uVovd< -1�ro _Rv 5r �,�o �If'� ,N0 <br /> z. �S ✓ L% /i'a _S{�c Ei • - 5_ 5 ,DSS Nw(e <br /> 1 <br /> 41 Umt3 <br /> 56. Int4 <br /> 7. I— <br /> 8. FIunit 5 <br /> 10. ❑unit 6 <br /> Specific Date Range of Information ReQuostcd: From to ! <br /> N (LOP) <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES q ��� I yr <br /> l`[•^UNDERGROUND TANK(UST)CLEANUP SITE LOP HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE /hl <br /> \t�JOTHER CLEANUP SITE(NON LOP) N ❑FOOD FACILITY ❑WASTE TIRE /',^ <br /> �.UNOFRGROUNO TANK(MONITORING(REMOVAL)YL ❑DOG KENNEL ❑DAIRY (M r'r . <br /> 4p TSAAZARDOUS WASTE GENERATOR �, ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> k. ❑T1EREO PERMITTED FACIE RY ❑MOTE(JHOTFL rJ❑- PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> S ❑TAIILO/BODY PH RCINc ❑POOI ISPA I_I LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASIC FACIU I ❑OfHI-R(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00pM(EXCLUDING HOLIDAYS) <br /> 1. List uo 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)464-0138 or mall 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 /> eeoaeos armor <br /> 1 <br />