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From:James Robinson Fax:+1(208)740.4303 To:Environmental Health Fax: +1(209)464-0138 2 of 2 723/2009 4:08 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY EHD LOG NUM <br /> 1 _C 9 C� ENVIRONMENTAL HEALTH DEPARTME T <br /> 600 East Main Street, Stockton, CA 95202-302 <br /> JUL 2 3 2009 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: Ww .sjgov.org/e <br /> ENVIRONMIENT LlEF.LIN PUBLIC RECORDS RELEASE APPLICATION <br /> ITnr <br /> APPLICAN : antes ROI)INSOn BUSINESS/AGENC JR SgnaTedCOI18nIYlllg Inc.1 <br /> ADDRESS: PO BOX 1744 __ CNy/State/Zip Vallt y Springs, CA 95252 _ <br /> PHONE(1): 209-772-3841 __ PHONE(2): Cell - 209-642-5445 F CSIMILE: 209-740-4303 <br /> TENTATIVE'APPOINTMENT DATE: August 6, 2009 ime: 9 am <br /> (Please allow 10 business days from date of application submittal-*Tentative onl -must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 07/23/09 <br /> Electronic Information: ❑ List ❑ Map -Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city <br /> 1- 1531 El Pinal Drive Stockton ❑ u12t <br /> q, loc on ❑ u <br /> 3- 2801 North West Lane Stockton <br /> 4. 1624 E.Al Ane Avenue Stockton unit 3 <br /> 5. <br /> 6 nit 4 <br /> 7. <br /> $ ❑ Unit 5 <br /> 8. <br /> ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> TA OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY In WASTE TIRE <br /> UNDERGROUND TANK(MONMORING/RemovA ) ❑DOG KENNEL ❑DAIRY <br /> u� <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> YY TIERED PERMITTED FACILITY ❑MOTELMOTEL ❑Pum ER TRUCK/YARD/CHEM TOILETS <br /> TATTOOIBODY PIERCING CIPOOL/SPA ❑LAND USE APPLICATION SITES MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:0 PM - 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 file type MUST be selected. Fax to(2091464-0138 or mail to thea dress 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 files exist. An appointment for review will te 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 foi 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 48-06 &04/08 PUBLIC RECORDS RELEASE APP FORM <br />