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0,5/01/2007 16:46 GEOM#X-RANCHO CORDOVA 4 12094640138 4k NO.753 1?02 <br /> DATE RECEIVED EHD LPG NUMBER <br /> SAN JoAQuuv COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E. Main.Street, Stockton,CA 95202-3029 <br /> Telephone;(209)468.3420 Fax:(209)464-0138 Web:N;rww.sjgoV gle <br /> PUBLIC 1r�RECORDS RELEASE APPLICATION <br /> APPLICANT: - \G- t .. T"''r'��-& BUSINEWAGENCV:G�M� IY L.(JT�SV ITU.Y1l � <br /> ADDRESS: D �^ W I .' ' C .7 n G `5&- f /� 7M^ <br /> PHONE(11; J 2� PHONE(2J: - �L- W FACSIMILE:�l10-In3{o"7 -5 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Pieria allow to business days from dato of application submittal•'Tentative only-meet bo confirmed) <br /> \/I Y�CHECK BOJ!TO EXPEDITE RE ST•$95.00 FEE(CASH OR CHECK DNLY)-REQUEST PROCESSED IN 3 BUSINESS <br /> SIGNATURE OF APPLICANT DATE / b <br /> Electronic information; []List Ej Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street a $treat Name City Unit t <br /> 1. �YI BigS CKkT <br /> 2. <br /> 3. Unit s <br /> 4. <br /> 5. <br /> 6. <br /> 7. � Ab Unit 5 <br /> 8. 74 <br /> 9 Unit 6 <br /> 10. <br /> Specific Data Range of Information Requested:From 11'k g(0 — to _C% -Uj--- 'T <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �8 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) -MHOUS(NO ABATEMENT 'la Soup WASTE FAcTLmNEHICLE <br /> 'S OTHER CLEANUP$ E(NON•LOP) "M.F000 FACILIry '67.ylAaTe TIRE <br /> `A UNPEROROUNDTANK(MON(TORNG/REMOVALI `R DOG KENNEL 'IMDA1RY <br /> HAZARDOUS WASTE GERERATOR .CHICKEN RANCH �Q WASTEWATERTRRATMENT PLANT <br /> �9 TIERED PERMnTED FACILITY "IMOTEUMOTEL -GLPUMPER TRUCKfYARDICHEA1 TOtLM <br /> --4.TATTD0/BOOV Pl=1100spy POOUSPA '19 Lao USE APPLICATION SITES <br /> �MEDICAL WASTE FACILITY `a�,OTNER(PLEAse SPECrY) <br /> WELL AND SEPTIC PERMIT RECORDS AREAVAILABLE FOR REVIEW - MONOAy-FRIDAY e: '6iODPM . EXCLUDING HOLIDAYS. <br /> 1. List up to ton addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)404-0138 or mall to the address Indicated above. Address <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. <br /> 2. The EHD will notify the applicant If any EHD flies 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 EHO staff may not be immediately available for review. A new application may be <br /> submitted when the file is avallable, <br /> 4. Any hie 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 /> EH04aea anyawe eoe <br />