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U612312005 14:03 916-371-1809 RANEY GEOTECHNICAL PAGE 01/e <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JO.AQUIN COUNTY <br /> f <br /> ENVOtaNMENTAL HEALTH DEPARTMENT <br /> 3014 East Weber Avenue,3r°Floor, Stockton,CA.95202-2708UN23' <br /> Telephone: (204)468-3420 Fax: (249)4640138 Web: WWW.5j9ay.0t9/0hdSAN <br /> PUBLIC RECORDS RELEASE APPLICATION 4rtt.VIP01'4 r� COUN <br /> � r A <br /> 9USINESIAGENCYWiA <br /> APPLGANT: <br /> A1apRESS: ITQ � �. .tC!`sP eoGA e <br /> PHONE(1):lfl�/5_7 47 5- ef FACSIMlL <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 buslness days from date of applicattan submKtal-'Tentative only-must be conflnned) <br /> CHECK BOX TO EXPEDITE REQUEST- HECK ONLY)-REQUEST PROCESSED IN 3 9USIME PAYS <br /> SIGNATURE OF APPLICANT DATE <br /> UNTF DISTRIUVTION G unit 1 nit 2 Unl alt A Unit 5 d Unit B ❑ Other(elecMmfclils4slmaps) <br /> FILE AWRESs <br /> EHD USE ONLY <br /> St"t Name CRY <br /> Speet# <br /> TP t ' <br /> � 7"ddJ. <br /> 3.._ <br /> Y3.45 <br /> r :51r�cr� <br /> '10.. .. <br /> Specific Date Range of Information Requested:From to <br /> EWRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(U"CLEANUP Srm(LOP) CI HOUSING ABATEMENT ❑SOLID WASTE FACILITYIVEHN:LE <br /> OTHER CLEANUP Sift(NON-L0F) ❑FOOD FACAM 17 WASTE TIRE <br /> ❑UNDERGROUND TANK(mown RINOIRemovx) ❑DOO KENNEL ❑DAIRY <br /> X HAZARDOUS WAM GENERATOR ❑CHICKEN RANCH XWASTEWATERTREATMENT PLANT <br /> ? ❑TIERED PERI imo FAcwrY ❑MOTELIHOTEL ❑PUMPER TRUCrJYARDICHEM TOILETS <br /> E3 TAsrooftay PIERCING Q POOLISPA ❑LAND USE APPudAmoN Sr1Es <br /> 0 MEDICAL WASTE KACI ITY ❑OTHER(PLEASE SPECIFY) <br /> WeLL AND SEPTIC PERMrr RECORDS ARE AVAILABLE FOR REVIew- MONDAY-FPMA'Y 81.00 AM-I 4Xru - ❑CCLuimNG HouDAYB. <br /> I List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the <br /> appropriate box(es). At least one file type MUST be s6lected. Fax to(209) e address <br /> Indicate34L0ov9._ 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 F-HO will notify the applicant if any EHL]files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after reacelpt of application. The files will be held f6r a maximum of fire business <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 available for,'review. A now <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 EHD staff aat the expense of the <br /> applicant, future file reviews by the same applicant may require a$9.1.00 deposit prior to review. <br /> END4842-096 <br /> 1154!05 <br />