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61/09/2008 15:01 2093345D'4 WGP SOUTHWEST NOCAL PAGE 01/01 <br /> DAAl=-G 11/E[1,r LLD <br /> �����I �' SAA JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Ar! 1 0 2008 600 East Main Strect, Stockton, CA 95202-3029 www <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web: ,sjgov,or <br /> EPd�i1)il NMiE T H'AL%H <br /> Z7 <br /> PER{„2'TiHEP�1!tCE! PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: I R`I 1- 5-H( ff 4A BUSINESS/AGENCY:_(t� 7 S xJ r H VJ�S(` <br /> ADDRESS: I G W e S l Ke e U i,V Com, �p D d_ <br /> PHONE(1): 1 _JL{ — 5363 PHONE(z); (p (o(� 'J <br /> FgCSiMIC.E:_)_OcI <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please Allow 10 business days from date of applicg,tion submittal-"Tenfatfve onl Ime. <br /> CHECK DOX TO EXPEDITE REQU ST-f98.00 FEE(CASH OR CHECK ONLY _ y-must be confirmed) <br /> REQUEST PROCESSED IN 3 B SINES DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE / Q <br /> Electronic Information: ❑ List C]Map-Description: <br /> FILE ApDrnii NLY <br /> S l 5 EHD USE O <br /> Street iX Street Name' <br /> ' city � unit 1 <br /> X03 CX�-yl <br /> -C1 � <br /> 3. ��� ❑ Unit 2 <br /> �3��0 _bD �2D3 <br /> 5. 3 ��LU► ' �a r Unit 3 <br /> - Unit 4 L``\ <br /> 7. <br /> 8. (] Unit 5 <br /> 9. <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested:From <br /> to <br /> _�, <br /> // ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> N NDERGROUND TANK(UST)CLEANUP SITE LOP d <br /> f1 THER CLEANUP SITE(NON-LOP ( ) HOUSING ABATEMENT -�'� � <br /> ) �FOOD FACICrTY �$ALID WASTE FACILRYNEHICLE ?�t.V <br /> UNDERGROUND TANK(MONrrORING/REMOVAL) ❑Doc KENNEL p WASTE TIRE <br /> HAZARDOUS WASTE GENERATOR 13 DAIRY <br /> 0 TIERED PERMITTED FACILITY C3 CHICKEN RANCH 0 WASTCWATER TREATMENT PLANT <br /> 173 TATTOO/BODY PIERCING 0 MOTEL/HOTEL In PUMPER TRUCK/YARWCHEM TOILETS <br /> 0 MEDICAL WASTE FACILITY 0 POOL/SPA 0 LAND USE APPLICATION SITES <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAC3 OTHER�R R(PLEA E SPECIFY) <br /> 7. List up to ten addresses in the space above. Select the MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS. <br /> box(es). At least one file type MUST be Selected. Fax t type(s) <br /> (s464-013 of file$form the at BbOVO by check <br /> il 11 th address g the ndicated aboyeroprlate <br /> ranges will not be accepted—for additional assist with file addresses,contact the EHD,Applications received after Address <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 review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies 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 file not returned In the same condition as released will be reorganized by EHD Staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD )7 <br />