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11 -Jan-2006 02125pm From-Younadahl 0 dtinQ Group , Inc 916 933 6482 % T-232 P - 001 /00i F-779 <br /> r1 <br /> DAYS RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH )DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www,sjgov.org/olid <br /> j PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: jjuf�rye _LS 1r4 we BUSINESS/AGENCY: t/oug4d2 � ��ry�C.OI7S'Lf 1�7I7C) <br /> ADDRESS: r7. 1 <br /> PHONE (1); .01(0 7�.__ J 3— �W S PHONE (2): (7 /402 Y17= 076 109, FACSIMILE• / 3 — ylFa <br /> TENTATIVE* APPOINTMENT DATE: Time: <br /> (Please allow 10 buslmw days from date of application submitfar - 'Tentative only - mvst be confirmed) <br /> OR/CHECK BOX TO EXPEDITE RE VE 'T - $93.00 EE (C R CH K ONLY) • REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN DATE / 11L <br /> UNIT DISTRIBUTION Unit 2 ❑ Unit 3 0 Unit 4 I7 Unit S 0 Unit 6 O Othor (clectronidlisu:/maps) <br /> FILEADDRESS USE ONLY <br /> Sheet <br /> # Street Name clry 034 <br /> 1 . 100 Ghar'If'ee- J61D4fgo <br /> 2. 5 D Choi ter )` \ \ <br /> 3 e�- W •1 <br /> 9. <br /> A 451 ICA <br /> 10- <br /> Specific Date Range of Information Requested: From - to <br /> 1 ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ar�l7NDERGRWND TANK (UST) CLEANUP SHE (LOP) 0 HoumNG ABATEMENT M/SDLIDWASTEFACRRYNEHI E <br /> �� CLEANUP SITE (NON-LOP) ❑ FOOD FAcIuTY 0 WASTE TIRE <br /> JINDERGRWND TANK (MONRORNG/REMOVAL) M DOG KENNEL ❑ DAIRY <br /> VNJIZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPERTRUCWYARO/CHEM TOILETS <br /> 13 TATToolSoDY PIERCING ❑ POGL/SPA 0 LANG USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY © OTHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR Rc rW - MONDAY-FRIDAY 8:00 AMS:o6PM - EXCLUDING HOUOA:'S. <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 mail 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 EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten (10) days after receipt of application_ The files will be held for a maximum of five 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 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 EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review, <br /> em as-0ia66 <br /> 1/14p5 <br />