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05/31/2006 LVED 10;44 FAX 559 "1 2886 BSK EnTironmental 2002/002 <br /> DATIr�3��g E�MF C) SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> �� �� vv ,f ENVIRONMENTAL HEALTH DEPARTMENT <br /> MA' 3 1 2006 304 East Weber Avenue,3`d Floor, Stockton,CA 95202-2708 <br /> ENVIRONMENT HJEM'one: (209)468-3420 Fax:(209)464-0138 web:www.sjgoy.org/etid 3 q3j <br /> PERMIT/SERMES PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCAUT; M)l�E �c-11 �- _BUSIINESSIAGENCY:-B5k A.ss <br /> IaAw aG1AT��y <br /> ADDRESS:-5-0 W. ,1 UCNVC� SUt� CA <br /> ��1EStiD1 93Z0�_ _ <br /> PHONE(I): 557. '/rl 7.2 F$6 EiCf 127 PHONE(2): 56 v 7 l ILE: :> . y . zp'r .._ <br /> TENTA11VE'APPOINTMENT DATE: �0 //OCt7 Tian: fDat7g <br /> (Please allow 10 bUslnesa days from date of application 3ubmhUl-"Tenta6va only-must W cjnfjmted) <br /> CHECK BOX TO EXPEDITEF7ES -;93.00 E H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ` t1:1A16 9 <br /> UNIT DISTRIWrION ❑ unit 1 ❑U Unit 3 C7 Unit 4 ❑Unit 6 C3 Unit 6 M Other(eWft'oni4.11i5t0mps) <br /> FILE ADDRESS ME-01`41 <br /> 'CeoT ee me <br /> 2. 4.4 V 77 ✓Y ON Jri U s U <br /> •-- a --- .- --- - . �.------------ -.�iYs.. o.. ---- ----------, <br /> 4. 3o o-? / NA✓Y O.0 ue- sn .✓6- <br /> 3,a t r n/A I/y�?i,a.✓E <br /> -2 p �A✓Y_A d'E <br /> SSSS __ <br /> Specific Date Range of Information Requested:From ! y0 to _ d —_— <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERCIRCU12D TANK(UST)CLEANUP$ITE(LOP) 0 HOUSING ABATEMENT ❑Soup WASTE FA(xrNfVEHICLE <br /> OTHER CLEANUP SrT(NOW-LOP) ❑FOOD FACILITY E3 WASTE TIRE <br /> UNDEP.GROUND TANK(MONrmRINGIREMOVAL) I]DOG KENNEL O DAIr;Y <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH I]Wm-TEWATER TREATMENT PLAN': <br /> T)zREO PERMITTED FACILITY ❑MOTEUHOTEL 0 PUMPER TRUCK/YAR0rQHE14 TON.ET3 <br /> TATTOOBODY PIERCING ❑POOLISPA ❑LAND USE APPLIC ATiON S=- <br /> ❑MEDICAL WATm FACILITY ❑OTHER(PLEASP SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVA)LABLE POR REVIEW- MONDAY-FRIDAY 8:00 AM-S.WM - ExcLUDING Hcuoms. <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mall to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The i;HD will notify the applicant if any EHD tiles exist An appointment for review will be confirmed <br /> approximately ten(10)days atter receipt of application. The files will be held for a maximum of five businers <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately ava liable for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file!not returned in the same condition as released will be reorganized by END staff at the expense of thl <br /> applicant Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> CHP.-";"X <br /> 11144cs <br />