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5 It <br />6 <br />7 3733 A27 -mandrivz, <br />/Unit 4 <br />No. 3530 P. 1 <br />EHD LOG NUMELR <br />Nov. 5, 2008 10:34AM Advr t a. I <br />DATE rtutivi=L) yVA C(A SAN Jo. N COUNTY <br />)(A', • 'ca \iN NN IRONMENTAL LEALTH DEPARTMENT - <br />600 East Main Street, Stockton. CA 95202-3029 <br />O 4q 4/5 t Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: ww-vv.sjgov.c.,TL <br />05 PUBLIC RECORDS RELEASE APPLICATION <br />i) R <br />1 <br />AFICANT: Ally Co lay '41,- 1 00 <br />cp A : 3 q-- Slloo.../ R L,c C7, <br />r'3111,. PHq!..I < );„2,0?- 116 7-- 1 b d ( o PHONE (2): FACSIMILE: -:=J /ZO'' //- If (0- 0 ,UO3 <br />:21:----- TENTATIVE* APPOINTMENT DATE Time: <br />Sl —... =..";-:7 _ --(411 e allow 10 business days fr m date of application submittal - *Tentative only - must be confirmed) ...-2 -- <br />A <br />CD ,•-'' <br />CHECK BOX T EXPEDITE REQUE - • $ .. S EE ( OR CHECK ONLY) • REQUEST PROCESSED IN 3 BUSINESS DAYS <br />-a-- SIgA APPLICANT DATE ii "q-g <br />FeTtronic Information: El List LII Map Description: <br />,ImmmommmmMW <br />BUSINESS/AGENCY: MA/at-tad oan viro pnvleitioti <br />a-r-vcV--+0 Crg 24S <br />2. <br />3. <br />Street # <br /> 3 3.3 <br />9. <br />10 <br /> FILE ADDRESS <br />Street Name City <br />5010'1, ekaiatte-L.orkf., <br />wi Sivck-ioin___ <br />tk I s It t <br />ct t <br />EHD USE ONLY <br />• <br /> LI Unit 1 <br />.2q 66 /.27 5" <br />G Unit 5 a <br />Unit 6 <br />Specific Date Range of information Requested: From <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (Nori-LoP) <br />UNDERGROUND TANK (MONITORING/REMOVAL) <br />XHAZARDOUS WASTE GENERATOR <br />0 TIERED PERMITTED FACILITY <br />71 <br /> <br />TATTOO/BODY PIERCING <br />0 MEDICAL WASTE FACILITY <br />HOUSING ABATEMENT <br />0 P000 FACILITY <br />10 DOG KENNEL <br />0 CHICKEN RANCH <br />17 MOTEL/HOTEL <br />POOL/SPA <br />d OTHER (PLEASE SPECIFY) <br />0 SOLID WASTE FACILITY/VEHICLE <br />WASTE TIRE <br />DAIRY <br />0 WASTEWATER TREATMENT PLANT <br />n PUMPER 1-Ruck/YARD/GI-ism TOILETS <br />1=1 LAND USE APPLICATION SITES <br /> <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW MONDAY-FRIDAY 8:00 Am-5:00NA - EXCLUDING HOLIDAYS. <br />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) 484-0138 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 />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 />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 />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 same applicant may require a $98.00 deposit prior to review, <br />END USE ONLY <br />END 48-06 WEB 8/9/2007 <br />to