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04/24/2007 08:56 530244,021 LAWRENCE ASSOCIA S PAGE 01 <br /> pATE RE-GL IVInD- G NUMBER <br /> SAN JOAQUIN COUNTY <br /> --, <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> it <br /> 600 E. Main Street, Stockton,CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov,org/ ..d <br /> 77 "PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: _ USiNES AGENCY: I siW rem/ -)--/)--S <br /> ADDRESS:_'SOD P\ckr L 0 I <br /> PHONE(1):5-?50 Q'7PHONE(2): CSINIIL.E:�30^Z.. i1f-50 <br /> TENTATIVE"APPOINTMENT DATE: 5-131 - <br /> (Please allow 10 business days from date of appl cation su i ust 6e continued) /q§ r <br /> A CHECK BOX TO EXPEDITE REQ ST-$95. CASH O N VEST PROCESSED IN 3 BUSINESS DAYSa7ttie <br /> 'G <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic information: ❑ i,.i8 Map—Description: <br /> FILI ADDRESS EHD USE ONLY <br /> Street>� Street Name city p 2 ❑ unit 1 <br /> 2. �r� (7I"� !1. as eq K ^�(-'3 Unit2 <br /> 105,00 m a A -A AIA <br /> v <br /> D6- 6. ^ � n us( r r `;g unit <br /> P' 7. x q8. t, <br /> f r e ❑ Unit 5 <br /> ...?o. :,�. ® .•��i C moi a�. <br /> Specific(Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACiUTYjVEHICL.R, <br /> CJngER CLEANUP 51YE(NON-LOP) O F000 FAciury WASTE TIRE <br /> UNDERGROUND TANK(MiONiTCRINOIREMOVAL) Q Dov KENNET. n"PJRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCN .8"WASTEWATER TREATMENT PLANT <br /> 'XTIERED PERwrrEO FACILITY 0 MOTEUHOTEL * 0 PUMPER TRUCKiYARDICmr=m TOILETS <br /> 0 TATrooMoDY PIERCING M POOLISPA ((�� � �e ❑LAND S$ PPLICATION SITES <br /> 0 MEO=L WASTE FACILRY �i OTHER(PLEASE SPECIFY)_.y16.04, Q ` {oti'K,,•_ <br /> WELL ANP SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM5:00PM - 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 fila type MUST be.selected. Fax 101201i)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications race ived after <br /> 3:00 pm will 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 tan(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 the that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> Q. Any file not returned in the same condition as released will be reorganized by EH13 staff at the expense of the applicant, <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> tb u11 C; oIG J -4o <br /> EHD 486E B/1 wan <br />