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May. 31. 2007 8:13AM AA.uanced GeoEnv ronmental <br /> <br />No. 8774 P. 1 <br />RE(77M° <br />MA\{ 3 I 2.007 <br />ENVIRONMENT HEALIti <br />PE SERVICES <br />APPLICANT: <br />ADDRESS: <br />PHONE (1): <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orgie <br />PUBLIC RECORDS RELEASE APPLICATION <br />FACSIMILE: <br />n-LUR, OtcV- <br />1 `54A-k.0 <br />sift -1006 PHONE (2): <br />El-ID LOG NUMBER <br />BUSINESS/AGENCY: AthttflArli &CC 6-ce. <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - Tentative only - must be confirmed) <br />CHECK BOX TO EXPEDITE RE T $ • 0 FEE )98H OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 5-31-(n <br />e UNIT DISTRIBUTION 0 Unit 1 0 Unit 2 0 Unit 3 0 Unit 4 0 Unit 5 0 Unit 6 0 Other (electronic/lists/maps) <br />FILE ADDRESS EHD USE ONLY Street N Street Name City <br />. 050 PreM011- 5'Irt 4 71 , OTA 1-4 Ko 5.2 . acoso 111.01-1\ 6r-• <br />— -- • g-(0 0 0 -11.1 -A,1-6r. goo -ikorin- es. j ,5- <br />4. <br />, f <br />____ <br />• ....:, • , <br />7. <br />• ...., <br />10. <br />Specific Date Range of Information Requested: From I (1St to pl-reyk., <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />0 HOUSING ABATEMENT <br /> <br />0 SOLID WASTE FACILITYNEHICLE <br />M FOOD FACILITY <br /> <br />0 WASTE TIRE <br />El DOG KENNEL <br /> <br />0 DAIRY <br />CI CHICKEN FtANCFI <br /> <br />0 WASTEWATER TREATMENT PLANT <br />0 MOTEL/HOTEL <br /> <br />0 PUMPER TRucK/YARD/CHEm TOILETS <br />POOL/SPA <br /> <br />CI LAND USE APPLICATION SITES <br />El OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW • MONDAY-FRIDAY 8:00 AM-5:00PM - ExcLuDiNci HOLIDAYS. <br />List up to ten addresses In the space above. Select the type(s) of files from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (2091 464-0138 or mall to the address <br />indicated above. Address ranges will not be accepted - for additional assistance with file addresses, contact <br />the EHD. Applications received after 3:00 pm will be processed the next business day. <br />The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br />approximately ten (10) days after receipt of application. The flies will be held for a maximum of five business <br />days for review. Appointments should be scheduled accordingly. <br />A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br />application may be submitted when the file is available, <br />Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />EHD 4642.006 <br />1/14/06 <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />17 OTHER CLEANUP SITE (NON-LOP) <br />UNDEROROUN TANK (MoNrroniNGIREmnv AL) <br />IfIC HAZARDOUS WASTE GENERATOR <br />TIERED PERMITTED FACILITY <br />fl TATTOO/BODY PIERCING <br />0 MEDICAL WASTE FACILITY <br />N3-5