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MAY. 3. 2006 3 1 PM CON OR EARTH TECH N0. 6865 ?. 2 <br />0 EHD LOG NUMBER, <br />-SAN JOAQUI N COUNTY <br />EwmoN'IVlJ AL HEALTia DEPARTMENT <br />304 Bast Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orl;/ehd 4V <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: _ 1' �^t X2-19- NJt4J <br />ADDRESS e 1 <br />PHONE (1): - C.SI B PHONE (2): _C <br />TENTATIVE" APPOINTMENT DATE: <br />(Please 6110w 10 business days from date of <br />CHECK 13OX TO EXP E ST - $93-00 F (CAS <br />SIGNATURE OF APPLIC T <br />UNIT DISTRIBUTION 1 ❑ UnKi ❑ Unit 2 13 Unit $ <br />M _ 11, <br />0 ► " <br />MEN <br />try ■"'�" <br />BUSINESSIAGENCY: <br />I©(- ODO;t FACSIMILE: e12 - 0l 71 i <br />Time /.'-;c> 17th <br />I submittal-*Timtaave only - must be confirmed) <br />HECK ONLY) . REQUEST PROCESSED IN S BU (NE}SS DAYS <br />'^ DATE ( C) to <br />4 ❑ Unit 5 ❑ Unit li ❑ Other (electrOnI0Ivtsllnays) <br />Specific Date Range of 1pformatlon Requested: From to <br />EHO USE MY <br />1 <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />4u UNDERGRoumo TAw (UST) CLEANUP Srm (LOP) HousiNG AeAT=ENT a SOW WASv FACuW/VEHIGLi: <br />❑ HSR Ct.ANUP SITE (NON-t.QP) ❑ FOOD FACILITY n WASTE TIRE <br />DERGROUND TANK (MONITORING1REMOYAL) ❑ DOG KENNEL ❑ yAIRY <br />F KAZAROOUS WASTE GENERATOR E3 CHICKEN RANCH 1►ASTEWATER TRE=ATMENT PLANT <br />11 TIERED PERMITTED FACILITY ❑ MOTEI Hom • ❑ PUMPER TRUCKIYARDiCHEM TOILETS <br />C3 TATT00/B0oY PI86te4NG M POOLISPA CI LAND UsF- APPLICATION Sam <br />❑ MEDICAL WASTE FACILITY ❑ OTmER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REvtEw - MONDAY -FRIDAY 8:00 AM-6:00PM - EXCLUDING HouoAYS. <br />1. List up to ten addresses in the space above. Select the type($) of files from the list above by checking the' <br />appropriate box(es). At least one file type MUST be selected. Fax to (2091464-0138 or mail to the address <br />indicated above. I Address ranges will not be accepted —for additional assistance with file addresses, contact <br />the EHD. Applications received after 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 <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments 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 <br />application may be 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 <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />END 45-%-006 <br />lfl"s <br />1 <br />4 �t <br />END 45-%-006 <br />lfl"s <br />1 <br />