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20/07/2008 17:31 <br /> 9 STRATUS NO CA!_TF PAGE 01/01 <br /> t <br /> ' EHO LOG NUMHER <br /> DD <br /> � SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCTis $ ZDQB 600 East Main Street, Stockton, CA 95202-3029 <br /> F� fn_ Telephone: (209) 468-3420.Fax: (209)464-0138 Web:www.sj 30vor <br /> �Ji�OKAT 1 HrwAL.TH <br /> PUBLIC RECORDS RELEASE APPLICATION r1 <br /> C , A1C. eUSINESSIAGENCY: � :�.�t � ''Fe�O <br /> APPLICANT: — <br /> ADDRESS: -�-3'30 Co-k-ne'tc'o 9CL(K �f S*�t Citylstaw/zip O e.r:� ra-ry CA 9sc� z <br /> ` PHONIE0)} 530) -3SS OnU4b EFR40 PHON1}Et2): C-1r (CCtt) FAGSIMiLE: <br /> TENTATIVE"APPOINTMENT DATF; l oh-'7 Time: <br /> (Plaase allow 19 business days from date of application submittal-*Tentative only.must be confirmed) I <br /> (71 CHECK BOX TO EXPEE)ITE R ST-$10S VEE( SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF,APPLICANT DATE <br /> Electronic Information: ❑ List El Map—Description: <br /> FILE ADDRE=SS EHD USE ONLY <br /> : Street# Street Hama City J ItlUSI,. tACIA16 ler LCWC tP -� �ack�rav,2. X202 Ua- t'>�+"rYlesr �- ��1° ciC�zn: �4 ❑ <br /> jAt,3 <br /> 5. <br /> 5. <br /> z9 6 7. <br /> 9 <br /> 10. <br /> Specific Date Range of Information Requested:From <br /> 1q0icl to ^QSe'tk <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES. <br /> E]HOUSING ABATEMENT Cl SOLID WASTE FACILITYIVL"ICLE <br /> } UNDERcaoUNo TAN1t(UST}CLEANUP SITE(LOP} p FAOD FACILITY ElWASTE TIRE <br /> 171 OTHER CLEANUP SITE(NON-LOP) El KENNEL d DAIRY <br /> C3 UNDERGROUND TANK(M0NIT0RINGIRRMOVAL) 0 WASTEWATER TREATMENT PLANT <br /> tO HA2'ARDOUS WASTE GENERATOR M CHICKEN RANCH ' <br /> E7 TIERED PERMITTED FACILITY E:MoTELIHPTEL ' 0 PUMPER TRucKfYARDICHFM TOILETS <br /> TAT roolgvaY PIERCING POOtJ$PA E3 LAND UsE APpuCATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) - - <br /> SNELL AND SEPTIC PERMIT RECORDS ARE AYAILAVILE FOR REVIEW- MONDAY-FRIDAY B:OO AM-5:40PM -'FXGLUDING HOLIDAYS- <br /> 1. List up to ten addresses in the space above. Select the type(-)of files from the list above by checking the appropriate <br /> box(es). At least one hie type MUST be selected. Fax to 209 ddress indicated above. Address <br /> 464-0138 nr mail to the a <br /> range*will not be accepted -,for additional ass istanoa with file addfessss,contact the EHD. Applications received after <br /> 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 bust ess be confirmed approximately. Appinme ten{�0) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <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 filo not returned in the same condition as released will be reorganized by EHE)staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> F-Ho USE ONLY <br /> PUBLIG FtECOR€lS RELEASE P.PP FORM' <br /> RHO 4MG 8144108 <br />_ I y <br />