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02/17/2009 16' 44 FAX 4159573 OOANE EfURRIS LLP-SF 40 Z 002/002 <br /> EHD LOG NUMBER <br /> (��� DATTE�EE.RECEIVED <br /> n SAN JOAQUIN COUNTY <br /> �]IC�L�IIv ENVIRONMENTAL HEALTH DEPARTMENT <br /> E00 East Main Street, Stockton, CA 95202-3029 <br /> FEB T 0 2009 Telephone: (2)91468-3420 Fax; (209)464-0138 Web: www.S190 . d T <br /> ENVIRONMENT HEALTW PUBLIC RECORDS RELEASE APPLICATION <br /> PERK) ,p"7ANr: ��L p Cw��en BUSINESSIAGENCY:PLIc <br /> W^� WVeCn�� Lyl�o� <br /> ADDRESS: _0'Ai L�aA L✓{ SAe H,�pwK, 5+1 <br /> PHONE(1): _ PHDNE(2): ` 'Z�ALTGGllyClSCta5talLip S1I1FA/CrStIMAI�LCUES <br /> : <br /> TENTATIVE'APPOINTMENT DATE: iaZ nj. TIM$: <br /> (Pleae allow 10 business days froubmittal <br /> � I <br /> -'Tentative only-must be OOnnrmad) <br /> M CHECK BOX TO EXPEDITE R;EQUES FEL-(¢A R CHECK ONLY)-REQUEST PROCESSED IN 9 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE �— <br /> Electronic Information: ❑ List 0 Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> F7, <br /> Stmat Name Clly ❑ ODIH <br /> Na rivL= S+ack�ol <br /> OltN�� qr Luo �;p7(J ❑ unit2 <br /> Unit3 : j <br /> -_ Unit4 <br /> ❑ Units <br /> g. ❑ unit 6 <br /> 10. — — <br /> Specific Date Range of Information Requested:From q 6 y to P <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERORODNO TANK(USI)CLEANUP SITZ(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITY VEHICLE <br /> ITER CLEANUP SITE(NON-LOP) 13FOOD FACILITY 0WASTE TIRE <br /> UNDERGROUND TANK(MONITORING <br /> ❑DOG KENNEL d DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY M MOTEL/HOTEL ❑PUMPER TRUCKrYARD/CHEM TOILETS <br /> 11 TATTOOIBODY PIERCING 13 POOL/SPA ❑LAND USE APPLICATION SRES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT REcoRDS ARE AVAILADLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-S:DOPM -EXCLUDING HOLIDAYS. <br /> 1. List up to tan addresses In the space above. Select the type($) of files from the list above by checking the appropriate <br /> box(es). At least one Rle type MUST be selected. Fax to(2091464.0138 or all to the address indicated above. Addregs <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 ne-t business day. <br /> 2- The EHD will notify the applicant f any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files 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 END staff may not be immediately available for review. A new application may be <br /> submitted when the file is avallabte. <br /> 4. Any file not returned In the same:ondition 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-$106 deposit prior to review. -- - - <br /> EHD USE ONLY <br /> EHD 4a-0e 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />