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08/12/2008 08:23 8252741103 ARCADIS * 40504 P. 002/003 <br /> RM", 0 SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> EN <br /> 2069 VIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> ENVIRr�N��7 c�RV SES telephone: (209)468-3420 Fax: (209)464-0138 Web:www.Sjgov.orglehd <br /> p��All1�l f7 / 43 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Lf-lah Near j BUSINESSIAGENCY:_�,1�G� 1S _ <br /> ADDRESS; Norih NfaI4 S'ttta,CM,?AD CITYISTATEMP: A)QInut (5eyfeh�—C�t <br /> PHONE(l): 96 -- �1/ PHONE(2): — — FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE; l�f_Gi"J Time: /O-'ab A" <br /> (Please allow 10 business days from date of application submlttal-'Tentative only-must be confirms <br /> f, :? <br /> CHECK BOX TO EXPEDITE REQUEST-$115.00 FEE(GASH OR CHECK ONLY)-REQUEST FSROCESSED 1N 3 -~aS DAY <br /> SIGNATURE OF APPLICANT •; ' <br /> BATE ��o'Z��,OO�J _ • <br /> Electronic Information: ❑ List RMap—Description: de Q <br /> FILE ADDRESS EHD USE ONLY <br /> 3trBet S Stmot Name City ❑Unit; <br /> 2. 3 iS7 IY , P-mi JrP_- obi T&rl <br /> oo -R2 \, <br /> 3• 11016 N Mwr S TvGle-r MjvX\ <br /> 4 3 o srn <br /> s _ Srpe-y-nr I <br /> it4 <br /> 7. 97-C t..LTb/v -.. <br /> V.__ ❑tlnle s <br /> 10. A)• JoS-c l r <br /> rut e <br /> Specific Date Range of Information Requested. From to 'AD6 �A L <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑i14U51NG ABATEMENT SOLID WASTE FACILITY LE <br /> OTHER CLEANUP SITE(NDN-LOP) ❑FOOD FACILITY a' WASTE TIRE <br /> UNDERGROITND TANK(MOtUORINGIREMOVAL) ❑UOG z E]DAIRY <br /> HAZARDOUS WASTE GENERATOR [�CfflA <br /> 0WAS1tWATER TREATMENT <br /> TIERED PERMITTED FACILITY ❑ML ,3 PUMPER TRUCKIYARDICHEW <br /> []TATTo41BODY PIERCING [IP LAM USE APPLICATION SrrES <br /> [) MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW MONDAY-PRLDAY 8:00 Am-5:00PM(EXCLUDING HOLIDAY$) <br /> 1. List up to tan addresses in the space above. Select the typo(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$115.00 deposit prior to review. <br /> END USE ONLY <br /> "*"if you need further assi=nce please contact Diane Martinez a {ZO>468-3425 directly. Thank You' <br />