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Jun. 19, 2006 10:46AM 0,,anced GeoEnyi ronmental No. 5231�Ho P. 2�uh,eER <br /> DATE k!:UtlVtU <br /> SAN JOAQUIN CO'LfNTY <br /> .ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-270$ <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/f'hd k.. <br /> •I l �:y rV� <br /> PUBLIC RECORDS RELEASE APPLICATION _ <br /> APPLICANT: U' n e en BUSINESSIAGE(N�CY: W nu _Eno <br /> ADDRESS: q _ !, 31 Q s� � 1L 1 �) `'7 5 a S p j F <br /> PHONE(1): &�D ! " 7 / '/jQQ� PHONE(2): 1 �'! 2S FACSIMILE:IIr <br /> TENTATIVE*APPOINTMENT DATE: <br /> Time: I <br /> 1� � <br /> (Please allow 10 business slays from date of application submittal-`TentaVve only-must be confirmed) <br /> GHECK BOX TO EXPEDITEMRT-$9300 <br /> OR CHECK ONLY -REQUEST PROCESSED IN 3 BUSINESS DAY i <br /> SIGNATURE OF APPLICANT DATE <br /> UrnT DI3TRISUTIO.M ❑ Unit 1 ❑ Unit 2 ❑ Unit 3 ❑ Unit 4 ❑ Unit 5 ❑ Unit 6 ❑ Other(elactronldlletslmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City <br /> 1 r f <br /> 2. 0. rt I^ e if V, F I <br /> 3. _3 v, ( z tl , <br /> 4. OQ Et II t l F <br /> - al I �r p <br /> 6• We-2-1006_ <br /> 7. l <br /> 8. <br /> SpeciTc Date Randa of Information Requested: From ��— <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUNCI TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑SaLk7 WASTE FACI�rTY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY Cl WASTE TIRE <br /> UNDERGROUNCI TANK(MONITORUJGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAzA;mous WASTE GENERATOR O CHICKEN RANCH ❑WX33TEWATER TREATMENT PLA <br /> TIERED PERMnTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARR/C1 Elk TOILETS <br /> ❑TATTOO/BODY PIERC;NG ❑POOLISPA J.AND USE APPLICATION Vres <br /> Q MUPICALWAS"E FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AOA-5:00pm - EXCLUDING HOLmAYS. <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 flye businges <br /> dabs 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 /> r <br /> EHD 4842-008 <br /> 1n4= <br />