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09/15/2009 10: 23 9257466099 AEI CONSULTANTS PAGE 01/01 <br /> (-1 EHD LOCA NUM6ER <br /> (LJ) �rL, 7E� SAN JaAQUaav COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SEP 1 5 2009 600 East Main St. Stockton, CA 95202-2708 <br /> ENUfR011PO!fdT HEALTH Telephone, (209)468-3420 Far. (209)464-0138 Web: www.sjgov.org1 <br /> 4 <br /> PERN"I T SERVICES PUBLIC RECORDS R_ELEASk APPLICATION �`J <br /> APPLICANT: _��� B�, StS/AGENCY: .T� _�Z'*[r��.SLlq\nC - � <br /> ADDRESS: Z-!7�Q ��� °� Q CITY6TATF-VP_ �.Y 114 C/ .4 Q&\ /�5n-j <br /> PHONE(1): 9 -2 tGTDd PHONE(2): FACSIMILE: ''2JS-7JV(0-(009) <br /> TENTATIVE'APPOINTMENT DATE: 11me: <br /> (Please allow 10 businss9 days from date of application submittal-•Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEUgt REQUEST-$105,00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT :2n,, DATE <br /> Electronic Information: 0 List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 4 5troat Name city ❑ Unit 1 <br /> 2 Unit 2 <br /> 3. ) <br /> 4. i <br /> __ _ __ ❑ Unit 5 <br /> 8. <br /> -� <br /> 9. Unit 6 <br /> 77 <br /> 10. <br /> Specific Date Flange of Information Requested: From ai:�;�C:AA to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SIT-F(LOP) Q HOUSING ABATEMENT OLID WASTE FACILITYIYEHICLE <br /> SITE(NON-LOP) ❑FOOD FACILITY a WASTE TIRE <br /> �FHER,01.114qu' <br /> D_ GROUNO TANK(MONITOPING/REMOVAL) D00 KCNNs2 DAIRY <br /> ZAROUS WASTE GENERATOR 0 CHICKEN RANCH r,�YASTEWATER TREATMENT PLANT <br /> C7 TIFF2I.PERMITTED FACILITY 13 MOTEUHOTFL 0 PUMPER TRUCKlYARDtCMEM TOILETS <br /> 171 TATTOOIBODY PIERCING 0 P00L1$PA Cl LANG USE APPLICATION SITES <br /> 10 MEDICAL WASTE FACILITY El OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC NRMT RECORDS ARE AVAILABLE FOR REVIEW-MONDAY-FRIDAY 8:00 AM-S;00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(20g)A640198 or mail to the add ss Indicated above.- 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 /> 2. The EHD will notify the applicant if arry EHD files exist. An appointment for review vAll be confirmed approximately ten(10) <br /> days after receipt of application. The files will be hold 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 EHU 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 reorganlzed by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$1115,40 deposit prior to review. <br /> EHID USF ONLY <br /> ***If you need further assistance please contact Diane Martinez a (209)468-3425 directly. Thank You""* <br /> 48-06 _ BKl4rmos <br />