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Apr 23 10 09: 47a Kr Associates 55934 p. 1 <br /> I^5 ECZ�VIEED EHD LOG NUMBER <br /> IIJJ LLISAN JOAQUIN COUNTY <br /> j9P'Z 3 2010 ENVIRONMENTAL HEALTH DEPARTMENT <br /> �Ea� u 600 East Main Street, Stockton, CA 95202-3029 <br /> ENDO NW V telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMITISERVECES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 36C-A BUSINESS/AGENCY: _LRPL_ '� RSSO(`_IPr(rGS, 1I�',. <br /> ADDRESS: 21S LTJ• FA'94)-`t,A-V3 City/State/Zip L( C7 %;.S CA 9 �, <br /> PHONE(1): S39. :'j 4'k. 0 0 06 PHONE(2): FACSIMILE: .171: ` • �i 4 S 9 <br /> TENTATIVE'APPOINTMENT DATE: P�SA-P Time: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 4-I;Z Ci(I o <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City El Unit 1 <br /> 1 SO LATH RC P Q P-). 11_PM_ ��P <br /> 2. igg4 LIN-MQDP � . Y 7O� (f�PF ,p -it <br /> 0001 <br /> 3. <br /> 4. nl 3 <br /> 5. <br /> Unit 4 <br /> 6. <br /> 7. <br /> ❑ Unit 5 <br /> 8. <br /> 9. Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From A'tll. to <br /> .,.,I ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> y(UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE �0 <br /> OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY WASTE TIRE <br /> XUNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH %WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELIHOTEL ❑PUMPERTRUCK/YARD/CHEM TOILETS <br /> O TATTOO/BODY PIERCING O POOL/SPA ❑LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 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 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 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 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 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 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 /> EHD USE ONLY <br /> j <br /> j <br /> EHD 46.06 8'04106 PUBLIC RECORDS RELEASE APP FORM <br />