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Apr, 8, 2008 15: 34 $RfV�& WINTERS No. 0660 P. 1/i <br /> dA� E 77'L' <br /> � EHL)LOG NUMBER <br /> J � SAN JOAQUIN Ca NTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 8 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0, 38 Web: www.Sjgov.or eh <br /> T'�ERVICE PUBLIC RECORDS RI=LEAS APPLICATION <br /> iSL <br /> APPLICANT: gI ,VAR G C t3 USINESS/AGENCY: K31K <br /> ADDRESS: <br /> PHONE(1)� �� PHONE(2) ry FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: 4 a Time- <br /> (Please allow ten bus i ays from dalk of ap Iication subm I•*Tmtatlry only-must be confirmed) <br /> CHECK BOX TO EXPEDITE RE EST- 98.0 FE (CAS I2=HECK -REQUEST PROCESSED IN THR£ BU INESS DAYS <br /> SIGNATURE OF APPLICANT DATE Q <br /> Electronic Information: © List©Map-O ption: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 4 Street Name City 0 Unit 1 <br /> 2. nt .x skin q(06 0unit2 <br /> 3. T3- VaF�ftftqi< <br /> 4. I W. o r"6U O C 10 <br /> 5• W.Ir"MDKJ $+, ,c1 c <br /> fi. (&b rim nit 4 <br /> 7. .F,r <br /> . ...... /U r r.r. Elunit's <br /> 10. ` p W• L i hof s Sf-- ckLjqQ A)F"1 r,lt 6 <br /> Specific Date Range of Information Requested;From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> cjNDERGROLIND TANK(UST)CLEANUP Srm(LOP) 4 H6u9jNC AeATtmEN7 M'IrOLID WASTE FACILMYNEHICLE i <br /> HER CLEANUP SITE(NON-LOP) O FOOD FACIi rTY M WASTE TIRE <br /> �tJNDERGROUNDTANK(MONITORINGIREMOVAL) 0 DOG KENNEL O DAIRY <br /> MIIA?ARDOUA WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> C3 TIERED PERMITTED FACILITY ❑MOTEL/HOT9L 0 PUMPER TRUCKIYARDICHEM TOILETS i <br /> ❑TATTOo1BODY PIERCING ❑POOLISPA C]LAND USE APPLICATION SITES. <br /> C]MEDICAL WASTE FACR.rrY I7 OTHER(PLEASE SPECIFY} <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY RIDAY 5:00 AM-d5:00PM - EXCLUDING HOLIDAYS. I <br /> 1. List up to ten addresses in the space above. Select the typo(s)of files t6m the list above by checking the appropriate + <br /> box(es). At least one file type MUST be selected. t e . Address ranges will <br /> not be accepted-for additional assistance with file addresses,Contact the EHD, Applications received after 3:00 pm will <br /> be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist, An appointmen for review will be confirmed approximately ten <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 the EHD staff may not be Immediately available for review. A new application <br /> may be submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganCred by EHD staff at the expense of the applicant 1 <br /> Future file reviews by the same applicant may require a$95.00 deposit rior to review. <br /> E14D USE ONLY r <br /> 1 <br /> EHD 4&Q6 16129107 <br /> PUBLIC RECORDS RELEASE APP frgRM <br />