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VII LF a GYYO Ivrj IU: Vd rxA I®441/441 <br /> DATE=RECEIVED EHD LOG NUMF39P <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: wway.sjgoV.Org! SS—,S—/ <br /> PUBLIC RECORDS RELEASE'APPLICATION <br /> APPLICANT: i L OC.r/ka C-L- BUSINESSIAGENCY: S K /"f�} <br /> `SSG f ct fL° C <br /> ADDRESS: 'b I f L Q D�1 [� I Cl)C� F N it 'sY L, 70 J <br /> PHONE fl): i Ci `h-57 • 92 q 3 HONE(z): f FACSIMILE: <br /> a TENTATIVE*APPOINTMENT DATE; gel_` I _Time: 4 <br /> (Please allow ton business days from date of applicalion submittal-'Tentaflve only•must be con'lifted) <br /> CHECK BOX TO EXPEDITE REQUEST-$98. CASH OR CHE Y)•REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT JC — ._ DATE <br /> Eintronic Information: K List❑Map-Description: _DQ I4 ctrl[rEAS /14Q JO <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street aX Street Name City ❑Unit t <br /> A-) If <br /> 2. `� - rI Trac 2:5 376 Dag" R OYM 0 Unit 2 <br /> 3 30f O 4' Tri c S <br /> /I!o c. <br /> 4 L1 Sp TG S Tra t q634540 ��.y mta <br /> 5 W Cera vrE 1 ; 2oAd 7 rata G D \ <br /> 6. 955-3 _..7�G�f-L 2C.t 7-rcLC S .54,7 ?, C�lt4 <br /> 7. U0 ra v►f- <br /> 18. <br /> $. 3(Q� CGti!i (I`f{2_. 66CLd TrCct S3-7 a4 0150.5 DUnit 5 <br /> 9. U-- W Ur��f /te, load 7'r�c rfS3(J _ 6 <br /> 10. nit 6 <br /> �..,� I <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> )GN'DE RGROOND TANK(UST)CLEANUP SITE(LDP) 0 HOUSING ABATEMENT VSOLID WASTE FACILRYfvEHICLE <br /> }�OTHERCLOANUP SrrE(NON-LOP) 0 FOOD FACILITY gWASTE TIRE <br /> f UNDERGROUND TANK(MONITORINwlREMOVAL) O D06 KENNEL 0 DAIRY <br /> HAZARoous WASTE GENERATOR d CHICKEN RANCH 0 WASTEWATER TREATMENT PLANr , <br /> 0 TIERED PERMITTED FACILITY 0 MOTEL.IHOTEL 0 PUMPER TRUCKIYARDICHEM TOILM <br /> C7 TATTOOIBODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION SITES <br /> Q MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) , <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REYIEW•MQNOAY-FRIDAY 8:00 AM-S:OOPM-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(2081464.0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> 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 <br /> days after receipt of application. The files Will be held for a maximum of free business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by the EHD staff may not be immediately available for review. A new application <br /> may be 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$98.00 deposit prior to review. i <br /> END USE ONLY <br /> EHD I846+0129)a7 PUBLIC RECDRDS RELEASE APP FDRM <br /> I � <br /> !L <br />