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Apr 1.45-04:.46p_. Drew Van AHE- E` 2(' 667-9668 p.i <br /> DATE RECEIVED I! EHD LAG NUMB <br /> APR i o SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`6 Floor,Stockton,CA 95202-2708 7z .'I <br /> ;{e'� Telephone: (209)458-3420 Fax: (209)464-0138 Web:www.sigov.org/efid . <br /> iia <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> rI APPLICANT: 1`1 p..� �.tAi <br /> ADDRESS: Z" V� t, �etv-L ��r i13CK SUSINESS/ACsENCY: ALD�X <br /> C� �(S 3 <br /> 7— <br /> PHONE PHONE(2): (Q4"t-' 43_";�- 4_7 <br /> ! FACS 4L[LE: '�f <br /> TENTATIVE*APPOINTMENT 3:/:DATE: 5 IIs Tima: <br /> (?lease allow 10 business days from date of appElcatiansubmittal-'Te1rlative only-must be corMrmed), <br /> E7 CHECK BOJ(TO EXPEDITE REQUEST-;93.00 FEE(CASH O" CHECK ONLY)I? <br /> =REQUEST PROCESSED IN 3 BUSINESS DAYS I <br /> SIGNATURE OF APPLICANT Dl�+nf�` <br /> 4 DATE 4 1 ► �0 5� II <br /> UNIT DISTRI6UT14N Ci Unit 1 CI Unit 2 t7 ti 3• Unit Unit 5; C3 .Unit 6 Q Other(electrenieAlStshnaps) ? <br /> r <br /> r FILE ADDRESS !I <br /> Street Street Name City ai EHDUSE ONLY 1 <br /> 1. G,rov+tl��nt <br /> Z _7,350 <br /> 3• `•l Q Mc..n S S�t,k �4 7� <br /> Ra..,,�w <br /> 6. cam t l3lvrl. a <br /> 7• !S4! W. �J a ULoh I <br /> �: <br /> El <br /> B. 4 I d4 a 5r1: Q q; <br /> .. <br /> 10- 3�-ss �s� �z. s,�x ., .�- <br /> 152 ff <br /> Specific Date Range of information Requested:From ZbG3 1 -2.<3:45I- <br /> • to <br /> } ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> WUNDFRGROLMTANK(UST)CLEANUP SCrE(LOP) ❑HOUSINGABATEuENT LI,SOLD wAsmFACtuTYfVEHzcLE <br /> E3 OTHER CLEANUP SrTE(NON-LOP) r3 FooD FAcEurY L7 wAsTa=TIRE <br /> E3 UNDERGROUND TANK(MONITORINGIReWNAL) El DOG KENNEL- 13 DAIRY <br /> C3 HAZARDOUS WASTE GENERATOR ❑CHCKEN RANCH II WASTEWATER ilRaarseNT PLANT <br /> C3 TIERED PERLir TeD FAEaurY C3 NOTELMOTEL i! Q PIASTER ATER T YA TMRC EfY[TOIT <br /> D TATTOOIBODY PIERcorG t7 POOLISPA LVS <br /> Q LAND Use APPLICATION SITES <br /> 4i <br /> 13(MEDICAL WASTE FACILITY fl OTHER(PLEASE SPECIP1 ! <br /> WELL AND SUMC PePANT RECORDS ARE AVAILABLE FOR REVIEW- I' oNDAY.FRloAY A:oo Ail.S.00 M - Ex==NG HOLIDAYS, <br /> I. List upto ten addresses in the space above. Select the types)of files from the list above by checking the <br /> appropriate box(es). At least one Ade type MUST be selected. Fax to"1200)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 END will notify the applicant if any END flies exist. An appointment for review wig be confirmed <br /> approximately ten (10)days after receipt of application. The flies will be held for a maximum of five business <br /> da s for review. Appointments should <br /> . Y pp be scheduled accordingly. I� <br /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new <br /> li application may be submitted when the file is available. ;i? <br /> 4. Any file riot returned in the same condition as released will be reorgafnized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00.deposit pylar to review. <br /> ie• <br /> EHD40�2-006 <br /> 111403 <br /> .t <br /> k; <br /> IF , <br />