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USI 2D. 200 3:10 PM KLEINFELDER NO 7411 P 1 <br /> ! rW`.4�=,1 - - EHD LOCI NUMBER <br /> ��f�, `J L=;U SAN JOAQUIN COUNTY <br /> _ Q <br /> ENVIRONMENTAL HEALTH DEPARTMENT w <br /> r 2 C19 600 East Main Street, Stockton, CA 95202.3029 I <br /> F Telephone: (209)468-3420 Fax: (209) 454-0138 Web:www.sjgov.or <br /> EivVRIA1110EI"I C <br /> PF_RN11TQu - '�jC PUBLIC RECORDS RELEASE APPLICATIO'NTO1 <br /> APPLICANT. giftBUSINESSIAGgNCY- <br /> ADDRESS: 1 I�.LG(�E� City/statelzlp M <br /> I <br /> PHONE(1): 3�1�'I'i!O! PHONE(2)- FACSIMILE,. C"0-3L82—_701$ <br /> f <br /> TENTATIVE*APPOINTMENT DATE: Da� V�v 19 Time: <br /> (Please allow 10 bUslness days from data of app) tion Submittal.'Tentative only-must be confirmed) <br /> d CHECK BOX TO EXPEDITE WUEST-$ 4S FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE O <br /> Electrorilc information: EDList[IMap—Description: <br /> FILE ADDRESS EHD USE ONLY 1 <br /> I <br /> Stmt III Street Name Gi [a Unit 4 i <br /> 2. ❑ unit 2 <br /> 3. <br /> 4. Unit s <br /> 5. unrt4 \. <br /> f 7 <br /> 8. ❑ Unit 6 <br />` 9. ❑ Unit 8 <br /> 1 t), <br />€ Specific Date Range of Information Requested:From to , <br /> I <br /> �� ENVIRONMENTAL HEALTH DEPARTMENT FILE$ <br /> itAZDARDOUS <br /> ER6R6iJND'�'ANK(UST)CLEANUP SITE(LOP) 11HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE <br /> ER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY CI WASTE TIRE <br /> f ERGROUNDTANK(MONITORINGIRemovAL) 13D00KENNEL d OAIR-f WASTE GENERATDR E3 CHICKEN RANCH 17 WASTEWATER TREATMENT PLANT <br /> Cl'f1EKaD PERMITTED FACILITY Q 11110EUHOTEL D PUMPER TRUCKIYARUICHEM TOILETS <br /> I7 TATTOOIBODY PIERCING 0 POOL ISFA C)LAND USE APPLICATION SITE$ <br /> I ❑MPINCAL WASTE FACILITY G OTHER(PL.GA$F SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAALE FOR REVIEW- MONDAY-FRIDAY 8100 AM-6:DOPM - ExCLuDING HOLIDAYS, _ <br /> 1. List up to ten addresses in the space above. Select tate type(s)of files from the list above by checking the appropriate � <br /> box(ea). At least one file type MUST be selected, ddroes indicated abM, Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 1. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirnted approximately ten(10) <br /> days after receipt of application. The files will behold for a maximum of five business days for review, Appointments I <br /> should be scheduled accordingly. <br /> t 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 /> i <br /> 4. Any file not returned In the same condition as released will be roorganized by EHD staff at the expense of the applicant. i <br /> Future file reviews by the same applicant may require a;105 deposit prior to review, <br /> EHD USE ONLY <br /> 1 <br /> EHD 48-06 6104108 PUBLIC RECORDS RELEASE App FORM I <br />