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FHD LOG NUWl F <br /> SAN JOA y <br /> T�NV1<RON117111VT ... ' 4 ,�'.k.0 Pr RTM.,��;N'T <br /> ii <br /> 600 East Main S. t,,, tockfon. CA 95202-2708 <br /> ` � �S Tcle fiolle: (209) 468-3.420 .l+ar.:.(209) 464-01 IS Wub: -�v-w,sjgo�'.org/ehd <br /> PUBLIC-RECORDS REL:GASE APPLICATION <br /> APPLICANT: BU51NES5lAGENCY: � nf—� <br /> PHONE(1): 1 "✓fJ PI IONS(2J: . l�� 'T :T FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: TirSie: <br /> (Please allay 10 business days from.date-of application s. ttai-'Tentative only-must b6 conflrmed) <br /> CHI=CK BOX TO EXPr=0lTC REQUEST-$ 00 EE tCASH OR QUEST) QUEST PROCESSED IN 3 H �U NESS DAYS <br /> SI N.AT RE OF APPLICANT <br /> �^ t7ATE <br /> Electronic Information_ ❑ List❑ Map—Description: <br /> r FILE ADDRESS EHD USE ONLY <br /> Street Street Name City. L unit 1 <br /> 2, e - // _ unit 7. <br /> unit 3 <br /> oe <br /> 4. _ <br /> Unit 4 <br /> 7' Unit 5 <br /> 4 _9 it Unit 6 <br /> Specific bate Range of Information Requested;From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> li )(UNDERGROUND TANK(LEST)CLEANUP SITk(LOP) ❑HousiNG ABATEMENT 0 SOLID WASTE FACILITVVEHICLE <br /> THER CLEANUP Sm (NON-LOP) d F000 FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MON ITORINGIPSMOVAL) ❑ DOG KENNEL C3DAIRY <br /> O..ARDOUS WASTE GENERATOR ❑ CHFCKEN RANCH - n WASTEWATER TREATMENT PLANT - <br /> 0 TIERED PERrAn TED FACtU Y El Ul0TeL1t-101tL 0 PUMPER TRUCKIYARDICHEM TOI vs <br /> E ❑TATTOOIBODY PIERCING 0 POOIJ PA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAI.WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> WEM.AND SEPTIC PERMIT RFCORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 5:00 AM-5:00PM - EXCLUDING HOLIDAYS, <br /> 1. I_fst up to ten addresses in the Space above. Select the types)of files from the Iist above by checking the appropriate <br /> box(es). At least one file type MUST be select-ed. Fax to[209)464.0138 or mail to the address indicated above. Address <br /> 1 ranges will not be accepted—far additional assistance with-file addresses;contact the EHO,Applications received after <br /> 3:00 prn will be processed the next business day.. <br /> 2. The EHb will notify the applicant if any EHD flies exist. An'appolntment for reviow will be confirrhed approximately ten (1 a) <br /> days after receipt of application. T112 files will bo hold far a maximum of five business days for review. Appointment: <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 EFID staff at the expense or the applicant. <br /> Future filo-reviews by the same applicant may require a$98,00 deposit prior to review, <br /> EHD USE ONLY <br /> "Rx If you should need f=urther assistance Blease contact Diane Martinez @.(209)46$-3425 directly, Thank You` <br />