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JUL 1 3 2006 <br />ENVIRONMENT HEALTH <br />Ira SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />i 304 East Weber Avenue, 3' Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.oreehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />END LOG NUMBER <br />SE--) s- mr? <br />AGENCY; ex-- <br />c24--04 <br />PHONE (2): FACSIMILE; <br /> 4L3? tiff <br />ADDRESS: <br />PHONE (1): <br />APPLICANT: Sig Li <br />co--) cQ <br />U2/24/202 07:03 2094671117 AGE STOCKTON <br />PAGE 01/01 <br />TENTATIVE* APPOINTMENT DATE. Time: <br />(Please allow 10 business days from date of application submittal "Tentative only - must be confirmed) <br />0 CHECK BOX TO EXPEDITE REQUEST - $93.00 F • (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINES_SDCS <br />A ./41 SIGNATURE OF APPLICANT Virpt••DATE 7-12 <br />UNIT DISTRIBUTION 1 0 Unit 1 1:1 Unit 2 C:1 Unit 3 El Unit 4 1:1 Unit S in- U'rt-it 6 I71 Other (electronic/lists/maps) <br />FILE ADDRESS <br />EHD USE ONLY Street 0 1 Street Name City <br />1'22 1 1 i•I elfilt-h 1/(1/ .I,, (..Itc tikhl,t <br /> Z2LL5____ it ci <br /> <br /> <br />6 IE <br /> <br /> <br /> <br />, <br />Specific Date Range of Information R.Aquested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />)NDIEROROUND TANK (UST) CLEANUP (LOP a <br />0 ER CLEANUP SITE (NON-LOP) <br />UNDERGROUND TANK (MONITORING/REMOVAL) <br />HAZARDOUS WASTE GENERATOR <br />TIERED PERMITTED FACILITY <br />0 TATTOO/BODY PIERCING <br />CI MEDICAL WASTE FACILITY <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 Am-6:00pm - EXCLUDING HOLIDAYS, <br />200 <br />fzEve4s . <br />0 HOUSING ABATEMENT <br />CI FOOD FACILITY <br />Do o KENNEL <br />0 CHICKEN RANCH <br />morzuHoTEL <br />POOL/SPA <br />OTHER (PLEASE SPECIFY) <br />0 SOLID WASTE FACILITY/VEHICLE <br />WASTE TIRE <br />CI DAIRY <br />WASTEWATER TREATMENT PLANT <br />O PUMPER Muck/YARD/Cum TOILETS <br />0 LAND USE AppLicATION SITES <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 (209) 464-0138 or mail 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 flies exist. An appointment for review will be confirmed <br />approximately ten (10) days after receipt of application. The files 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 MID 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 />END 443-02-096 <br />1/14/0G