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Oct 08 2007 1 : O1PM Ge�ogica IOnc 1 415 17-7880 1 <br /> 1C P� o29� V <br /> �I 0 2007 <br /> DA 'ER&JVED <br /> SAN JOAQUIN COUNTY EHO LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Jelephone: (209)468-3420 Fax:(209)464 0138 Web:%vww,j .o h57fo <br /> \2-3029 � <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: / 'C G tT ( f BUSINESS(AGGENCY: G f O 05_C <br /> ADDRESS: Sb ({ d,,I,.e f 0. ^a"(r D C i (( J v I <br /> PHONE(1): Yrs' Fj-2 PHONE(2)' <br /> FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: <br /> (Please allow 10 business days Ir Time: <br /> om date of application submittal••Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST 08.0 FE� H OR CHECK ONLY)-REQUEST PROCESSED IN a BU INE DAYS <br /> SIC,NAT E OF APPLICANT DATE /D Q <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street _ Street Name <br /> Z yo 1 1 _ P S L City - ❑ Unit i <br /> � __ <br /> 2- 0 4fj,41/ <br /> •� l4 C ❑ ume2 <br /> 1 3' lip C <br /> q& <br /> a. ( 2q0 T <br /> 6_ <br /> Unit 4 <br /> 7. <br /> 6. ❑ Unit 5 <br /> 9. <br /> 10. ❑ Unit e <br /> Specific Date Range of Information Requested:From /?do to r,p-t c,. <br /> ,.r ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Y-UNDERGROUND TANK(UST)CLEANUP SRE(LOP) <br /> 6.OTHER CLEANUP SITE(NON{QP) Cl LI <br /> HOUSING ABATEMENT ❑$OD WASTE FACILITYNEHICLE <br /> y ❑FOOD FACILITY ❑WASTE TRE <br /> t+e UNDEROROUNO TANK(MONITORINGIREMOVAL) In Due KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH 11 WASTEWATER TREATMENT PLANT <br /> TIEREDPERMnPE PIERCING <br /> FACILITY 71 MOTELIHOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 MEDICAL WASooy PIERCING 0 POOLJSPA ❑LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW. MONDAY-FRIDAYS:OOAMS:DOPM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above b checkingthe a <br /> riate <br /> box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the address Indicated abovepp <br /> ranges will not be accepted-for additional Resistance with Nle addresses,contact the END. Applications received after <br /> 3:00 Pm will be processed the next business day. <br /> 2. The END will notify the applicant If any END 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 rive business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked an by END staff may not be Immediately available for review. Anew application maybe <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$98,00 deposit prior to review. <br /> .. <br /> END USE ONLY <br /> EHD 1Sa6 WEB A/fi(1GOi <br />