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Jul. 13. 2000' 2.53PM *-iced GeoEnvi ronmental - No. 5480. P. 1 <br /> DATE ktL'tIVtU �HU Lv�a��UU3ER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor; Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax- (209)464-0138 Web:www.sjgov.org/ehd <br /> • PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT- U heD6 QPS e0 BUSINESS/AGE{N�CY: S__ <br /> _ Nv <br /> ADDRESS: n� S�7 /�p�*t`_( Q J V�-1 /� 'l� J �y b <br /> PHONE(1): tJt lJ J " 7 i ! '-! ,0y() PHONE(2):(� 9— / - �/�"J 9) FACSIMILE: C1 — <br /> TENTATIVE*APPOINTMENT DATE: 19 J0 6 �pQ& Ll'wej Time: p r'earl, <br /> (Please allow 10 bu$inesa days from date of application subm-ittal-'TentaBvo only"must be confirmed) i p P a <br /> CHECK E OX TO EXPEDITE:�����CVECK ONLY)-REQUCST PROCFS5EI7 IN�3p B IN(+S"DAY, <br /> SIG �TURE OF APPLICANT DATE ol, <br /> UNIT DISTRIBUTION © Unit 1 CfUntt2 ❑ UN S ❑Unit 4 ❑ Unit 5 ❑ Unit 6 ❑ Other(electronic(llstSIMAps) <br /> FILE_ADDRESS EHD US ONLY <br /> Street r Street Name Ci <br /> 1. as a 'Ali JKIF <br /> 2. lr r, rr 4 <br /> 3. Q ft et lr <br /> 4. <br /> 5, a -to <br /> 7• I t`0 t L C <br /> A <br /> Av trific Data Range of Information Requested:From ,�oo.� to <br /> OnL,,% — ENVIRONMENTAL HEALTH DEPARTMENT FILE$ ' <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOF) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑Wm'm TIRE <br /> NDERGROUND TANK(MONITORINGIRWOVAL) M DOG KENNEL R DAIRY <br /> HAZARC)OUS WASTE GENERATOR ❑CHICKEN RANCH 0 WA.R7EWATI;R TREATRIEN'r PLANT <br /> 0 TIERED PERMITTED FACILITY C]MOTELIHOTEL C3 PUIWPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTOWBODY PIE)ccm,' ❑POOLISPA WLAND USE APPLICAT10N SITES <br /> El MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL A?ID SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 6:00 AM-5:00PM • EXCLUDING HOLIDAYS. <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(2091464-0138 or mall to the address <br /> indicated above. Address ranges will not be accepted–for additional assistance with file addresses,contact <br /> the EHO.Applications received after 3:00 pm will be processed the next busin©ss day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for r6view WH be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days 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!bay 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 revievvs by the same applicant may require a$93.00 deposit prior to review. <br /> EHO 48412.808 <br /> 11140 <br />