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11/04/2008 11:08 9259442Q99 TSG - PAGE 01 <br /> SAN JOAQUINCOUNTY EHa Loi NuMaeR <br /> NU V 4 2008 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1300 East Main Striet,Stockton, CA 95202-3029 <br /> FNNI ONMENT HEALT►relephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> !q ZwW <br /> PUBLIC RECORDS RELEASE APPLICATION c <br /> APPLICANT: Yu 9USINESSIAGENCY: 1`k SwrCA lyu . <br /> ADDRESS: 3 til gCKY//State/Zlp <br /> PHONE(1): ��2 ��`�-ZB�G� onEl2): �5ro� yro"f!_t/..b FACSIMILE: ^Z ✓ <br /> TENTATIVE*APPOINTMENT DAT2- Time:_an-T ry-'Q <br /> (Please allow 10 business days frft dato of applicatio ubmitial-*Tenfatrve only.must be confirmed) <br /> CHECK BOX TO E7CPEbITE M4U - <br /> $105 FEE V CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List❑Map—Description: rl Ott 1t'n Inc- <br /> FILE <br /> nc- <br /> FILE ADDRESS EHD USE ONLY <br /> Street o Street Hahne City ❑ Unit 1 <br /> 'I- � �P CdIV1. <br /> 2. ❑ unit 2 <br /> F <br /> 3. <br /> 4. Unit 3 <br /> 6. <br /> 6. Unit 4 <br /> 7. <br /> 91. ❑ unit b <br /> 9. <br /> 10. ❑ Unita <br /> Specific Date Range of information Requested:From f 23 t q to <br /> ��,,��tf ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> lq UmaRGROUND TANK(UST)CLEANUP SITE(LOP) 0 HousING ABATemmr 0 SOUD WASTE FACIUTYNEHICLE <br /> IR OTNBR CLEANUP SITE(NoWLOP) D FooD FActuTy Q WArre TIRE <br /> UNDERORouNo TANK(MONITomNp/ movAL) D Doc KENNEL D DAtRY <br /> C HAZARDOUS WASTE GENERATOR 13 CMCKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> []TIDED PERIWITTEo FACIuTY O MOTEL/HOTEL la PUMPER TRUCK/YARO/CHEM TOILETS <br /> D TArroo/BoDv PIERCING 0 POOLISPA D LAND USE APPLICATION SITES <br /> D MEDICAL WASTE FACILITY D OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PEurr RECORDS ARE AVAILABLE FOR REVIEW-MoNDAy-ftoAY 8:00 AM.S:001PM -EXCLUDING HOUI)AYs. <br /> �. List up to ten addresses in the space above. Select the type(*)of fifes from the list above by checking the approprtate <br /> box(es). At least one file type MUST be selected. FIX to(2091464&138 or mail toindicated 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 any EHD files exist An appointment for review will be confirmed approximately tan(10) <br /> days after racelpt 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 EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file is avaliable. <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$105 deposit prior to review. <br /> EH13 USE ONLY <br /> r � <br /> I <br /> EHD 48.08 8/04/08 <br /> PUBLIC REGORDS RELEASE APP FORM <br />