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EHU LUIi NUMtltK <br /> E$ !V,ED� SAN JOAQUIN COUNTY .� <br /> L` <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> L01j 600 East Main St. Stockton, CA 95202-30 <br /> „F hone: (209)46B-3420 Fax: (209) 464-0138 Web: rgleh <br /> E; <br /> il` _S PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: I �l l c BUSINESSIAGENCY: C= cM 92(c Z�o <br /> ADDRESS: IJ cJ)2 z o CITY/ISTATpERIP: <br /> PHONE(1): 3R PHONE(2): 1510-05-Lp2(o0 FACSIMILE:510-2�1S- 2S/- <br /> TENTATIVE*APPOINTMENT DATE: F-_ k(L& 2 2 V Time: S A dr <br /> (Please allow 10 business days from date of appilcatic submnta •Te tW only-must be confirmed) <br /> �CHECK BOX TO EXPED=QU�� 5115 F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS AYS <br /> SIGNATURE OF APPLICA DATE C9 Z5 <br /> Electroniclnforrnation: &List ap- trip n: 1 6r0v,ev1e k) u <br /> FILE ADDRESS #414r,# EHD USE ONLY <br /> Street i Street Name city iarl Unit 1 <br /> 1• 230 h CA LAS+h'ir-_ tee. lio 5r°L Il <br /> 2• tg WN d 1 unH2 , <br /> 4. o Kmcia, Ve- 1 Unita <br /> 5. �j S 4- AJC 67 T L 0 NO (e'r <br /> 6. 2 i W . tit a l n S Unit <br /> 7. )i l rci 1 901 <br /> z o <br /> 8. ZZ-70lhk]l I U 1 Unit5 <br /> 1 No <br /> 70. 2 lid—pCO yt� nh6 (-( <br /> Specific Date Range of Information Requested: From P 0-r _C o QSe W\I <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACIUTYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTETIRE <br /> NDERGROUND TANK(MONRORINGIREMOVAL) ❑DOG KENNEL L <br /> HALIRDOUS WASTE GENERATOR ❑DAIRY <br /> `/.Q�`�. CHICKEN RANCH .,[�a�•ASTEWATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY QI' ❑MOTELIHOTEL U PUMPER TRUCKIYARDICHEMICAL TOILET <br /> ❑TATTOOIBODY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1, List 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)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 kx' <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> ONLY (� <br /> (000051 S <br /> 6 r `A . 6R r r r 3L5 <br /> EHD 4846 n <br />