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04/18/2007 11:17 E108340152 PAUL H KING PAGE 02/02 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> FNVIRONMJI NTAL HEALTkI DEPART1V i NT <br /> 04 Fast Weber Avenue, 3T`I Floor, Stockton. CA 95202-2708 <br /> ']Cele hone: (209)x}68-3420 Fax: (209)464-0138 Web: www..qjgov.org/elid7C) <br /> U�L1C RECORDS RELEASE APPLICATION <br /> APPLICANT: I. � BUSINESS/AG N Y: A L� r ' 1C <br /> ADDRESS= <br /> PHONE(1): ��D " ` PHONE(2): FACSIMILE:, SI�'�„-1�.�?L <br /> TENTATIVE'A POINTMENT DATE: 1 f f Hr,� $`� 3; Time: <br /> (Please allow o business dayq from date of application submittal-*Tentative only-must be confirmed) <br /> fl CHECK BOX TO EXPE ITE REQ $95.0 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT -DATE <br /> Electronic Information: List 0 Map--Description: <br /> FILE ADDRESS _ _ END USE ONLY <br /> -- <br /> El <br /> Street# Street Name ---- _--- •.--- City s ✓L//�,j I•- I Z� Pt's Unit 7 <br /> ra <br /> Unit 2 <br /> 2. <br /> ` 3. 1 D L4 1`= Unit 3 <br /> - -- <br /> 4. <br /> --- -- <br /> —- - <br /> 6. � Unit 4 <br /> -- <br /> 7. -— - .- ❑ Unit 5 <br /> 9. - — -- — ----- --- - _— ❑ UnK 6 <br /> Specific Date Range of Infor atlon Requested: From to <br /> ,./''� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> LJ LINpERGROUND TANK(UST)CL NuP SITE(LOP) ❑HOUSING ASATEMENT n SOLID WASTL FACiLITYNLHICLE <br /> I�0 ER CLEANUP SITE(NON-LOP C1 FOOD FACILITY ❑WASTF_TIRE <br /> UNDERGROUND TANK(MONITORI GIRF.MOVAL) ❑DOG KENNFL D DAIRY <br /> !_fiAZARDOUs WASTL-GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILfTY d MDTEUHOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTO0iBODY PIERCING In PoOLISPA LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PE MIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses i the space above. Select the typo(s)of files from the list above by checking the appropriate <br /> box(es). At least one file pe MUST be selected. Fax to_( 09 4134-0138 ori nil to the address indicate-above. Address <br /> ranges will not be accept d-for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processe the next business day. <br /> 2. The EHD will notify the a plleant If any EHD files exist, An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of appli atlon. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled ace rdingly. <br /> 3. A file that Is actively beln worked on by EHD staff may not be immediately available for review. Anew application maybe <br /> submitted when the file is available. <br /> 4. Any file not returned in th 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$95.00 deponit prior to review. <br /> eHb USE ONLY <br /> EHD4n.os en3iaooe ..^ <br />