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17/2009 16: 44 FAX 4159573001 UUANE 110RRIS LLP-SF 002/002 <br /> DATE RECEIVED END LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> E,00 East Main Street, Stockton, CA 95202-3029 <br /> FEB 1 u 2009 Telephone: (279)468-3420 Fax, (209)464-0138 Web:www.sjgO . d <br /> ENV!RONNIEW HEALTh PUBLIC RECORDS RELEASE APPLICATION <br /> PE,RW 4 1113,r nIN< <br /> r� Aecrk'a C�Gv <br /> APPLICANT: �' fir. 0. �G.� '� BUSINESS/AGENCY= _ __— <br /> ADDRESS: 0-,&- M0AAX'+ +J VJAA S r 11IIJ Z(�M City/State/Zip S.r, rr4 nC LT GC1 4 e A , q q _ <br /> PHONE(1): YI�� O _ PHON`Ef(2): `�� ?�" 3605 FACSIMILE: <br /> TENTATIVE`APPOINTMENT DATE: V `•-wr—(^- _ f_zdo I Tlme; 10 <br /> (Please allow 10 business days from data of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUES PF.G PA R CHFCK ONLY)-REQUEST PROCESSED IN 9 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information., ❑ List❑ Map—Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> r2. <br /> 0. rL04 S+ac.k�sh o`I( N�� grL�'CS��kiv� 14PPa�ce � oWWUnit2i�.ld _ Svc k-4�^ <br /> Unita <br /> 4. T �� <br /> w — _ --- Unit 4 <br /> ti. <br /> 7. __ ❑ Unit 5 <br /> 9. ❑ unit G <br /> 1 D. <br /> Specific Data Ranco of Information F.equested: From q 6 to fo <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> tNOCROROUND TANK(UST)CLEANUP SITE(LOP) n HOUSING ABATEMENT ❑SOLID WASTE FAC(LITY/VEHICLEl HER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY 0 WASTE TIRE wdDERGROUND TANK(MONITORING/REMOVAQO� 13 DOa KENNEL rl DAIRY •{ / <br /> HAZARDOLIS WASTE GENERATOR C1M CHICKEN RANCH WASTEWATER TREATMENT PLANT 1 <br /> !0 TIERED PERMITTED FACILITY M MOTEUHOTEL 13 PUMPER T'RUCKJYARD/CHEM TOILETS <br /> CJ TATT001BODY PIERCING n PDOL/SPA ❑LAND USF APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY n OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECJRD9 ARE AVAILAULE FOR REVIEW -MONDAY-FRIDAY 8:0Q AM-5:00PM -EXCLUDING HOLIDAYS. <br /> 1. List up to ton addresses in the apace above. Select the type(s)of tiles from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2099)464-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Appllcatlons received after <br /> 3;00 pm will be processed the neat business day. <br /> 2. The EHD will notify the applicant f 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 carne applicant may require a$106 deposit prior to review. <br /> EHD USE ONLY <br /> . r [Ami s 6 I <br /> EHD 48-06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />