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Apr. 30. 2007 �0: 06AM AT.'1 GROUP SERVICES INC. No. 0382 P, 2 <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL.HEALTH DEPARTMENT <br /> 600E.Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)4640138 Web:www.sjgov.org/ <br /> P,;, <br /> `:'' ` PAUBLIC RECORDS RELEASE APPLICATION <br /> APPLIC`iMl `: Ni i A 1 I 11 <br /> • �•- - -. l BUSINESS/AGENCY: C oCtct�e5 <br /> ADDRESS:r�� 5151 fIA�IihB a94 �y <br /> PHONE(1):�-�V"1}2101'22 `by <br /> a PHONE 5)10 FACSIMILE-112-M) '141 - 222S <br /> TENTATIVE}ARpo1NTMENT DATE: l?1 I12V 1 Tlmr: '0 n <br /> (Plaaw allow 10 business days from data dt applicatlon submiMal-"Tentative Only-Moet be eonffrad) <br /> 13 CHECK BOX TO EXPEDITE RE T- 95.00 FE ( H OR CHECK ONLY)=REQUEST PROCESSED IN 3 USINt SS DAYS <br /> SIGNATURE OF APPLICANT DATE Oft JU 'VI <br /> Electronic Informatlon: ❑List EA Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street 0 Stmt Name City ❑ Unit i <br /> S D ' t Sioc �, v <br /> 2• M604 <br /> DO LOti1e THE R D Yt ❑ unit 2 <br /> s• Louie -Tyee,. \oh <br /> [4. I2S V{IC a UnR3 <br /> 5- ;- LOY)F Ree ESCOI5oY) >�k <br /> 6. IS206 &+e(neotW Rck I t&cak I oyi � � unity <br /> 7. \5-Z 52 Ste %Y)a +n d I 'Ecvkj cm -.4-© Units <br /> s. Is4m e'ne 1 12d cot k dh <br /> E.19o <br /> 15635 eine "l 'ESCa 1 on UnitIt <br /> Is6b S��'thQ l f� ESCOtloh- <br /> Speclflc Date Runge of Mformatlon Requested:From &� INYM1.AWLIE to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> fNDEFtGM0UNv TANK(UST)CLEANUP Wre(LOP) Q HOUSIN13 ABATEMENT G SOLID WASTE FACIUfYN MIGLF <br /> ER CLEANUP Am&(NON-LOP) 0 FOOD FACILITY 0 WAsTe Tine <br /> EROROUND TANK(MONTTO MOfREMOVAL) G DOG KENNEL E7 DAIRY <br /> bWASTE GENERATOR d CFacKEu RANcm E7 WASTEWATER TREATMENT PLANT <br /> ED PERMnTED FACILnY a MOTELIHOTEL PUMPER TRUCWYARD)Cnem TOILETS <br /> Eo TATTOOIBODY PIEMNa O POOLISPA 0 LAND USE APPlJcATIDN$ITE9 <br /> 0 MEDICAL WASTE FACHM 13 OTHER(PLEMe SPECIFY) __„• <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR PZMW- MONOAY-FrcDAY S:00 Am-$:*OPM - ExCLume HOLIDAYS. <br /> 1• List up to Eon addresses in the spate above. Select the type(s)of Tiles from the list above by checking the appropriate <br /> box(es)_ At least one fIe type MUST be selected. Fax to 1209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted—for additional assistance with fila 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 H any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The fil"will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. j <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may he I( <br /> submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganked by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may raquira a$9s.00 deposit prior to review. <br /> EHD USE ONLY <br /> I <br />