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07/24/2007 11:49 530887 -,"-H BLACKBURN PAGE 01/01 <br /> ��'�t1/tTE R� IVFq�' EHD LOG NUMBER <br /> << SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTME <br /> °, <br /> E; 4 - <br /> 600 E.Main Street, Stockton,CA.95202-3029 <br /> Telepbone'(209)468-3420 Fax:(209)464-0138 Web:www.s ggov /e <br /> PUBLICRECORDS RELEASE APPLICATION <br /> APPLICANT: �/-' BUSINESSIAGENCY: <br /> ADDRESS: 21 4,642 yyt1 r�e7 <br /> � <br /> P14ONE(1): �L��T <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date o appllcAt sub Itt -*Tentative only-must confirmed) <br /> Isal"CHECK BOX TO EXPEDITE REQUEST-$46.0 OR ECK LY)-REQUES IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT E !' <br /> Electronic Information: ❑ List El Ma Description. <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name 91ty UnItl <br /> 2. ����►t �,...._ ❑ Unit 2 <br /> Unit 3 <br /> Old <br /> U t4 <br /> 1e <br /> 9. softZI <br /> 10. El Unit 6 <br /> Specific Date Range of Information Requested:From Ll/ to <br /> J� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ! UNDERGROUND TANK(UST)CLEANUP SITZ;(LOP) M HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> ER CLEANUP SITR(NON^LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ERGROUND TANK(MONITORINGIREMOVAL) 0 POG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 17 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELMOTEL ❑PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑TATTOOIBODY PIERCING 1:3 POOLISPA ❑LAND USE APPLICATION SITES <br /> C MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 3:00 AM-5:00PM . EXCLUDING HOLIDAYS. <br /> I. 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(209)_434-0138„or mail to-the address(ndteated.above_ Address <br /> ranges will not be accepted—for additional assistance with rile addresses,contact the EHb.Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any EHD files exist. An appointment for 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, 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$85.00 deposit prior to review. <br /> EHD USE ONLY <br /> END 49.09 9113/2006 web <br />