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08/19/2010 08:34 FAX 9168529'=' Geocon Consultants (x001/001 <br /> DATER <br /> EHD LOG NUMBER <br /> � SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St Stockton, CA 95202-3029 <br /> (209) 468-3420 Fax: (209) 464-0138 Web; wwwsjgov.Org/ hd <br /> ��pp SE PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: P1r.ild 'F:52D!c'W BUSINESSIAGENCY: GEL-3cot-1 C1tiISL7l�dr�r� <br /> ADDRESS: _ 3(SpD �Dt J) tl�l.; f �� CITYISTATFOP: &wAo CA QQL4Z <br /> PHONE(1):(NO SSZ-ci I ( $ PHONE(2)<:W?)(4Z8-q(oa S FACSIMILE:CQ(!d) $�7 -Q l 32r <br /> TENTATIVE*APPOINTMENT DATE: -Z {.f fl Time: I "00 <br /> (Plane allow 10 business days from data of appllWOon submitral--TentatM only-must be confirmed( <br /> CHECK BOX TO EXPEDITE REQUEST-$122 FEE(CASHORCHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIG ATURE OF APPLICANT � ( � DATE S (c{-- (C) <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Snests Street Name city nN7 <br /> 1401 [Gvr4 r S ALX k 7tnl NO /t10 <br /> ._Zi I Ci cfA a�1c r- IA <br /> 4. 55DAAL.D o+J U Z nit3 <br /> s. L U T E51 tQ1 <br /> 8' nh 4 <br /> T: <br /> B, d unhe <br /> 8. <br /> ba <br /> S IIItfDfAfng Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT RSOLID WASTE FACT t t y1i <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE ' '' d•'e'e�M4 <br /> UNDERGROUND TANK(MONITORINOIREMOVAL)P'— ElDOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR a L]CHICKEN RANCH nn�yyWASTEWATER TREATMENT PLANT 63% <br /> TIEREDPERMITTEDFACIUTYp(\ ❑MOTEUHOTEL (PUMPERTRUCKIYARDICHEMICAL TOILETSa <br /> TATTOO/BODY PIERCING ❑POOL/SPA u LAND USE APPLICATION SITES �^ <br /> 4 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) 6 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-B:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above by checking the appropriate <br /> box(as). At least one file type MUST be selected. Fax to 12091494-0199 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. Applications received after <br /> 3:DO pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recelpt of application. The files will behold 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 END staff at th _ ap,pf the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review, ,-`.,ria ,kyr <br /> END use ONLYILi4WA) TV <br /> RHO 4 W % <br />