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SEP -25-2008 09:39 FROM -COLLIERS if <br />ATIONAL 9252790452 0 T-230 P.002/002 F-132 <br />DATE RECEIVEDEHD LQG NUMBER <br />- SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />699 l=ast Main Street, Stockton, CA 95292-3029 <br />3 Y, Telephone: (298) 468-3420 Fax: (209) 464-0138 Web: Www.sJ9ov.ar9/ehd <br />i PUBLIC RECORDS RELEASE APPLICATION <br />'APPLICANT ;y 2' pusINESSIAGENCY: 6z) I I1 <br />ADDRESS; i �, C2 7 Clty/Statelzlp � �r° c � — <br />PHONI: (1):13 �jLZ PHONE (2): s^ SX2 9 -3 Q-27 FACSIMILE: 92-S- P 22 1 Leri <br />TENTATIVE°' APPOINTMENT DATF- I Gt.GL.Tim*- „--jo -' 190 a, -VA <br />(Pleas* allow 10 business days from dare of application submittal - ^Tentative only - musbet confirmed) <br />M CHECK ROX TO EXPEDITE REQUEST <br />SIGNATURE OF APPLICANT <br />I.Electronic Information: 0 Lint [:j MaP — <br />e.a.,a�a..vea�a,s rmia,apu.®n,aeaA• <br />,anew <br />DRES <br />--- PILE D <br />street Street N <br />ame <br />1. pe S <br />z. <br />3. <br />4. <br />5. <br />7. <br />s. <br />(CASH OR G CK 6NI_Y) - REQUEST PROCESSED IN a au IN 53 DAYS <br />DATE fi <br />0tion: <br />ENO USE ONLY <br />_ CItY [� Unit 1 <br />Q unit 2 <br />tlillt� <br />Unit 4 <br />Q Unit b <br />Q Unit 6 <br />Specific pate Range of Information Requested: From _ to <br />r ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />r S3NAERGROUNP TANK (UST) CLEANUP SITE (I 0P) M HQuSING ApATFMENT CI SOLID WASTe FACIOTYNEtUCLF } 1� <br />, �TMR CLEANUP SITE (NON -I -OP) P FOGA FACILITY 0 WASTE TIRE <br />Xa UNPFRGROUNo TANK (MANITONNGIRFMOVAL) to Doc KFNNI:L Cl DAIRY <br />,Z'HAZARDOUS WASTE GENERATORA G CMIFKEN RANCq Q WASTFWAT6R TREATMENT PLANT <br />A TIERED PFRMITTEn FACILITY Q MQT90HOTE4 Q PUMPER TRUCK1YARp1CF{FM TOILETS <br />A TATTOOIRoRY PIERCING A P00LISPA G LAND (ISE APPOCATION SITES <br />Q MEDICAL WASTE FACILnY CI OTHFR (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RFFQRDS ARE AVAILApLF FOR REVIIEW - MONDAY-FRIpAY fi:e0 AM-5:00pm - 5XCLUp;NG HgWDAYS. <br />1. List up to tort addresses in the space above. 80100 the typos) of files from the list Above by checking the appropriate <br />box(os). At least one file type MUST b0 selected. Pax to (208) 4638 or mail to.1hy adcjrefis inligated ahove Address <br />ranges will not be accepted — for additional desistance with file addresses, contact the Islip. Applications received after <br />3:00 pm will be processed the next busineim day. <br />2. The EHP 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 />S. A file that is actively being workod 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 $106 deposit prior to review. <br />EMD USE ONLY <br />