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89/15/2009 10:23 9257466099 AEI CONSULTANTS PAGE 01101 <br /> 47 Eiif)LOGhlUiUiBEif2RMITMEDD SA,N �OAQLI�N CQUNTY <br /> ]ENVIRONMENTAL HEALTHY EPA RTMENT <br /> SEP 1 5 2009 600 East Main St. Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax.(209)464-0138 Web. WWW.sjgov.M/ <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICE B PUBLIC RECORDS RELEASE A-PPLICATION <br /> APPLICANT: e— '' I BUSINES&!AGENCY: <br /> ADDRESS: ^+�Q �� `�y+l� CITYISTATEIZR � <br /> PH a NE(i); �7 25-7�i I, fad_ ..-__pHaNE{2}: FACSIMILE: 2.S { <br /> TENTATIVE'APPOINTMENT BATE: I rMe: <br /> (please allow 10 bu*inoss days from date of applicntfon tubmittal-'Tentative only•must be confirmed) <br /> 0 CHECK 8OX TO EXPE017M PXQUEST-$106,00 FEE(CASH OR CHECKI ONLY)-(REQUEST PROCESSED IN 3 R INESS DAYS <br /> SIGNATURE OF APPLICANT DATE- <br /> I <br /> Electronic Information. [] List[3 Map—Description: .I ----- -- <br /> FILE ADDRESS AHD USE ONLY <br /> Street# Street Name city! ❑ unit 1 <br /> oft <br /> 2. �`'1� � i Unit 2 <br /> 3. ) <br /> + ❑ Unit 5 <br /> $• _ I Unit 5 <br /> 10. <br /> apeCific Date Range of Information Requested,.From I to d' <br /> I <br /> ENVIRONMENTAL.KEALTH DEPARTMENT FILM <br /> {ioEROROUNl7TAryK(UST�CLEANUP511£(LOP) 0HoualncAsA MPuT �nLibWASTEFAC0.1TYNEHICLE <br /> HER CLEANUP Slrc(No1r.LDpry >]F4pn FkdLITY a WA9TETII;E <br /> ROERC4ROUN0 TART[(MONRORINWREMOVAL) a Boo KENNEL. 0 1]AIRY <br /> RE, 5 W 8: GENERATOR rl CH1CKSN RANCH AfkBTF-WAT�TREATMENT PLANT <br /> E]TIt3Rtso PERMITTED FACiLr[v ❑MOTELIHOTk Q PUMPER TRUGMYArRUtOMEMTo1LfiT9 <br /> ❑TATT001BOIIY Plt=RCING CI POOLISPA U Lwo U$s APD>.ICATION SITU <br /> *MEDICAL.WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDSARE AVAILABLE FOR REVIEW-MOM)AY- MAY 8:00 AM+5i00PM - EXCLUOING HUt.IDAYS. <br /> 1. List up to tan addrenEgR In the space above_ Select the types)of files from the list above by checking the appropriate <br /> boxes). At least an&fiile type MUST he selected. Fax t 09 +464-0438 or Mail to the ad ss Indic0ed above Address <br /> ranges will not be accepted-for additional assistance YNth file addresses,contact the EHD.Appficatlons 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 appointpient for review will be confirmed apprnximatety 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 /> S. 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 available, e <br /> k Any file not returned In the same condition as released vAIll be r anlzed by EMD staff at the expense of time applicant. <br /> Future file reviews by the same applicant may require a$105.00 deposit prior to review. <br /> EHO USI_ONLY <br /> ***If you need further assistance pjewe contact biane Mortine2 0 (2179)468-3425 directly. Thank You*" <br /> I <br /> 48-06 $per�ooe <br />