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E RECEIVE© EHU LUU NUMbtK <br /> �� Ii SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT � T <br /> ,c�a 'r LU 600 East Main St. Stockton, CA 95202-30 <br /> phone: (209) 468-3420 Fax: (209) 464-0138 Web: " rg/ehd* <br /> PUBLIC RECORDS RELEASE APPLIG TI <br /> APPLICANT: <br /> --e—10 BUSlNESSIAGENCY: <br /> ADDRESS: J�2 © crmsTATEEizip: <br /> PHONE(1): 5 - 3 PHONE(2): 51 0-(o?5-(P 2(c 0 FAcsiMiLE:510-2c15 - 265 , <br /> TENTATIVE"APPOINTMENT DATE: `-[ , ck(:un , 2. ; Lo) u Time: Z A vv- <br /> (Please allow 10 business days from date of applicatl submi "Te tadve only-must be confirmed) <br /> CHECK BOX TO EXPEDIT QUE -$115 F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU (NESS AYS <br /> SIG TURE OF APPLICA DATE (9 Z5�/ <br /> Electronic Information: &List Aap- cript n: '-,Kv e 0 an <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name cityUnit 1 <br /> [2. t lC)l\ I�.d Unit2 <br /> (� Q C� V e ® Unit 3 <br /> 6. <br /> unit <br /> 7. '2 j IrO� i 1 r <br /> . 22:7 D 01 U Unit s <br /> 9. 'j <br /> 10. (� 2 � - CO Lf T Unit 6 <br /> Specific Date Range of Information Requested: From P I- y- e o �e <br /> ENVIRONMENTAL REALTH DEPARTMENT FILES �- <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACIL.ITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR d ❑CHICKEN RANCH ASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY (� ❑MOTELIHOTEL MPER TRUCK/YARD/CHEMICAL TOILET <br /> //❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(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(209)464-0138 or mail 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 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$115 deposit prior to review. <br /> 5. if you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> ONLY tJ` dip\ <br /> to 17- - 9 S� o +0 N. <br /> I-, <br /> 1'i •(600©51 - �D - �c® <br /> (L �- <br /> E r 13z5 <br /> EHD 48-06 ztF'4D � <br /> 6 , 6 r <br />