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From'0NC <br /> ' 2099825757 03/08/2009 01:41 #708 P.001/001 <br /> DATE RECEIVED EHO LOG NUMBER <br /> ilk L <br /> 'I i CflL". 600 East Main Street, Stockton, CA 95202-3029 <br /> (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.Orjg1 4d2. 730 <br /> -PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 17--1 <br /> Cfty/Staterzip _M4,M" en' A"I.F7 �7' <br /> PHONE(1) PHONE( FACSIMIL <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application subm'MI-*Tentative only-must be Confirmed) <br /> 0 C14ECK BOX TO EXPEI]IrA�ST, $ 15 OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU!�INESS DAYS <br /> SIGNATURE OF APPLICANT `7 <br /> DATE <br /> Electronic Information: List 0 Map—Description: <br /> FILE ADDRESS END USE ONLY <br /> street# Street Name city <br /> 2. Unit 2 <br /> 3. <br /> Un <br /> 5. <br /> [6. Unit4 <br /> 8. <br /> 9. <br /> El u <br /> 10 <br /> Specific Date Range of Information Requested; From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> *ND, CLE NNUP SIT E(LOP) 11 HOUSING ABATEMEN­r 11 SOLID WASTE FAciLrTYIVEHICLE <br /> RDO E GEN.11 D CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTEL/HOTEL 0 PumPER TRucKIYARDICHEm TOILETS <br /> C3 TATToo/BooyPIERCJNG 13 POOLISPA E3 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY C3 OTHER(PLEASE SPECI <br /> . WELL AND SEPTIC PERMIT RECORDS ARE AvAiLABLE FOR REVIEW- MONDAY-FpjoAy 8:00 Am-5:00PM -ExCLUDiNG HOLIDAYS, <br /> I. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the END. Applications received after <br /> 3:00 pm will be processed the next busIness day. <br /> 2. The END will notify the applicant If any EHD flies exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of applicatlon. The files wIll be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordlngly. <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 releasad will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit,prior to review. <br /> END USE ONLY <br /> EHD 48-06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br /> | <br /> n <br />