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/oATt RECEIVED 1 % �,,. tF7U LOU IVUMCtK <br /> „I SAN JOAQUIN COUNTYwa <br /> — ENV ONMENTAL HEALTH DEP)ARTM dt'T [ <br /> 600 East Main St. Stockton, CA 95202 30 - g 4 <br /> Teterhone: (209) 468-3420 Fax: (209) 464-0138 Web: w t rg/eh i <br /> i ;115 ",'l'ii;_cs PUBLIC RECORDS_ RELEASE APPLICATION i <br /> APPLICANTBUSINESSIAGENCY: 1= CM 9 Z.(c Z(o <br /> ADDRESS: &2 VQ Z00 CITYISTATEIZIP: <br /> �__ <br /> PHONEPHONE(2): 51 (,o -� FACSIMILE- 10-2C15— 2 5(0 <br /> TENTATIVE"APPOINTMENT DATE r{ d k ? 'Zo1O Time: 8gvv� <br /> (Please allow 10 business days from date of applicaU submi `Te radve only-must be confirmed) <br /> STACHECK BOX TO EXPEDIT QUE -$115 F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU 1NESS AYS <br /> TURE OF APPLICA DATE (s ZSR <br /> Electronic Information: El List Z IIWap- cript n: (t J Orl <br /> FILE ADDRESS to EHD USE OY <br /> street# Street Name City Unit 1 <br /> 1. 23 0 1 V L,_S+lvi� �C :�cD �. " <br /> 2. o /� C , <br /> e �1 t 1711 I�� 4$ `: Unit2 <br /> 3. 2 h S �L4O11 <br /> 4. (� Q.- C).. Ve- i s ����`..a' Unita I <br /> S. 3 5 S d OC � a Ave <br /> S. 2 W . fel a'I n S Unit 4 <br /> s. 22.-7o 0-w- 9 '3 - ❑Unit5 ## <br /> its i <br /> 10. I 2 ;?' l.s unit <br /> Specific Date Range of Information Requested: From Q Y_I -CM7 I to P e K) <br /> ENVIRONMENTAL REALTH DEPARTMENT FILES " <br /> §ONDERGROUND TANK(UST)CLEANUP SITE(LOP) . ❑HOUSING ABATEMENT - 2fSOUD WASTE FACILITYIVEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY , <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH .,[��{y�p�ASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL LJ PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> I <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un 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 `V <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. '1 <br /> 2, The EHD will notify the applicant if any EHD files exist. An appointment fo'r 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.IA 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' <br /> by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$115 deposit priorto review. - <br /> S. If you need further assistance, please contact Diane Martinez,at(209)468-',3425. ' <br /> END USE ONLY <br /> EHD 46-06 <br /> 8127109 <br /> i ✓-t <br />