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FRON �,Ci 2caliHist .:.cal con PHONE. NO. 510 6548535 JUL: @7 2011 00:450N P1 <br /> � E �. �� <br /> ' % <br /> J U� , Z�l l l AN JOA QuIN COUNTY EHD l.OG NUMBER <br /> ENVIRONMENTAL F NMENT/.IL HEALTW DEPARTMENT <br /># <br /> !ENVIRONMENTAL HE' TIie1 Ft 600 <br /> D East Main St. Stockton, CA 95202-3029 <br /> PERMITISERVICE pane: (209 468-3420 Fax: (209)444-0938 Web: www4gov.arg/ehd <br />' PUBLIC RECORDS RELEASE APPLICATION <br /> I <br /> APPLICANT: BUSINESS/AGENCY:/�/ C` //�!/ C� <br /> ADDRESS: � ���� � -- �L.. <br /> CITYISi`A fel(': . <br /> PHONE(1): 1p & �3 PHONE(2): . <br />{G TFN7ATIVE*APAOINTMlTI�lT DATE: _ FACSIMILE: tC, <br /> (Please allow 14 business days from date of pvllcation ubl ami Tentative onEl l Tirrle: <br /> CHECK BOX TO F_Xptt)rrF REQu T-$122 FEE(CAS O CH ' L Y'M—t be Conti►medj <br /> SIGNATURE OF APPLICANT -: EQulrsr Pl�ocessr=o Ir+l s sus nrESs r3Ars <br /> DATE j <br /> Electronic In :1 <br /> �List[I Ma _Description: ... LL <br /> FILE ADDRESS <br /> • r <br /> EHD USE ONLY <br /> Street R y <br /> Street Name City <br /> unit i <br /> C <br /> 2. <br /> 3. 1�� unit 2 <br /> 4. I <br /> 5. 1 nit3 <br /> s. <br /> 7. unit 4 <br /> � S l <br /> 8. <br /> L✓. -�a�Ca�� s . unite <br /> 8. cF � � .. �� 17 <br /> Unix <br /> SPQCMc Date Range"of Information Requested, From to _ <br /> ENVARONMEWAI.HEALTH E)EPARTMEN-t FILES <br /> 21I1NDERGROUND TANK(UST)CLEANUP Sat(LOP) ❑HOUSING ABATEMENT <br /> �RER CLEANUP SITE(NON-LOP) ©Fooli FACILITY Q WASTE FACI!ITYNEHICLE <br /> EIINDERGROUND TANK(MoNrmRINGIREMOUAL) ❑DOG KENNEL ©WWASTE TIRE <br /> L�'4AZARDouS WASTE GENERATOR [:1 DAIRY <br /> ❑CHICKEN RANCH ❑WASTEWATER Tf2EATMi;NT,PLANT <br /> ❑TIERED PERM117ED FACILITY ❑MOTELIHOTE <br /> [3 TATTOOf�OpY PIERCING �POOIISPA ❑NMPER TF2UCKIYARUICHIl411CA1 TQIE_ET$ <br /> Q LAND USE AppucAnoN Sms i <br /> ❑MIZOIcaL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECOtzIa.S ARE AVAILAaLl~FOR REVIEW: MIIUNDAY-FRIDAY 0!00 AM-i:OQpM(EXCM)PINa HOLIDAYS) <br /> 1- Ust un to ten addresses in the spa60 above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At lOaSt one file type MUST be selected. Fax to(2091 q§ ..pf3S or mail fo dd <br /> ranges will nut be acre ���indicated bene Address <br /> g pted-for additional assistance with fife addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed tho next business day. <br /> 2. The EHD will notify the applicant if any EHC fifes exist An,appointment for review will be confinned approximately Cron(10) <br /> days after receipt of application. The files will be held fora 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 availsbfe 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$722 deposit prior to review: <br /> Eft U$E ONLY <br /> 07MMO , <br />