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Near. J. 2009 14: 18 BROWN & WINTFRS No, 3477 P. 1 <br /> EMD LOG NUMBER <br /> L -OAN JOAQUIN COUNTY <br /> ENVIRONMeNTAL HEALTH DEPARTMENT <br /> MAP, 200" 600 East Main Street, Stockton, CA 95202-3029 <br /> N1\i Telephone: (209)468-3420 Fax: (209)484-0138 Web:www,sjgpv. h <br /> PEMr'yi' 4F E3 PUBLIC RECORDS RELEASE APPLICATION <br /> ArPNE(l): <br /> �1hmff 0j47Hj AV Al BUSINESS/AGENCY. �RawH a�WlN,�� (LAW Lcwp) <br /> AQ0 Q 19MjjV',l+A4n DRIVE f p� City1mateop C,40IFG„ C4 gAV07 <br /> P7/00 033-9y8_r PHONE(2): 760 0 i q--739.2 -_FACSIMILE: <br /> TENTATIVE*APPOINTMSNTDATE. �'h >2c-* /(g I --IoOfp Tlma: % <br /> (Plose allow 10 bushes ays from date of application submittal-'TsnfaHr4 only-must be confirmed) <br /> E3 CHECK BOX TO EXPEDITER EST FEE 8H ojksWcK ONLY)-REQUEST PROCESSED IN S BUSINESS DAYS <br /> GNATURE OF APPLICANT DATE - 3— amu <br /> °lectronlc Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street I>e Street Name City Unit 1 <br /> 3y5� Al. 01tf_m1r-2r rsr srackr <br /> SITE C.P-11 a I' end 6074 ❑ UnIt2 <br /> � (� S�vCkr��1 ST�e � rr�iv I f unit 9 \ <br /> moo. <br /> - Unit 4 <br /> 7. <br /> 13. Q Unit 5 <br /> 9. <br /> ❑ Unit 6 <br /> 10. <br /> Specifio-bate Range of Informatlon Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 56ND&OROUND TANK(U$T)CLEANUP SITE(LAP) 0 HOUSING ABATEMENT 17 SOUD WASTE FAcILRYNEmcLE <br /> G OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY_ 0 WASTE TIRE <br /> ;4UNDERGROUND TANK(MONITORINGIREMOVAL) C3 DOG KENNEL 13 DAIRY <br /> M HAzARD0vs WASTE GFNERATOR 17 CmCKEN RAMOH ❑WA$TEwATER TREATMENT PLANT <br /> CI TIERED PERM=rD FACILITY 17 MOTELIHOTEL 0 PUMPER TRUCKIYARWCHEM T0ILFT5 <br /> TATTOOIBODY PIERCING G POOLISPA G LAND USE APPucATION SITES <br /> MEDICAL WASTE FACILnY In OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONOAY-FRIDAY 8:40 AM-5:46PM - EXCLUDING HOLIDAYS. <br /> 1. Ust 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 4640138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for addldonal assistance with file addresses,contact the EHD. Applications recelved after <br /> 3:00 prh will W 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 SCCOrdingly. <br /> 3. A file that Is actively being worked on by END 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 reorganised by END staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 4W6 3104M PUBLIC RECORD$REL W E APP FORM <br />