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May- 18. 2006 9: 52PM Advanced GeoEnvironmental No. 4936 '. 2 <br /> DATE RECEIVED EHD BOG NW,19ER <br /> RD E (j I' I� SAN JOAQUIN COUNTY <br /> (v7 U^U U ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 <br /> FLAY L006 Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> ENVIRON10M F HEALTH PUBLIC RECORDS RELEASE APPLICATION Z3 "? Iq <br /> APPLICANT: U h dn -BUSINESS/AGENCY; Cy_N1 <br /> ADDRESS: 121) s Q 'I J <br /> PHONE(1): DQ& PHONE'(2); 016 r1� FAcsI�nILE: D�- � 7 ���l ) <br /> TENTATIVE*APPOINTMENT DATE:. 2 �l KEN A Time: 1jQ-O'0 10 _ <br /> (Flease allow 10 business days from date of app11,a11on submittal-"Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE E T-$93,00 FEE(CA CH K ONLY)-REQUEST PROCE§SED IN 3 BUSINFSS DAYS <br /> SIGNATURE OF APPLICANT - DATE / "� <br /> UN IT DISTRIBUTION ❑ Unit If Unit2 ❑ Unit3 ❑ Unit4 ❑ UnitS IC Unite ❑ Qther(electronlcAistslmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> $treat Street Name Ctty <br /> 9. u / C <br /> 11 toes-1- 14 agwq 161 <br /> 3. 57 0 tr c( <br /> AA A <br /> r6, <br /> v trS C <br /> u e. C 4 —1 <br /> W/V'Gaitar/111A <br /> 9. <br /> Specific Date Range of.lnformatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILE$ <br /> �UND£RGROUN17 TANK(91ST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT C1 SOLID WASTE FACILITYNEHICLE <br /> THEIR CLEANUP SITE(NON-LOP) 11 FOOD FACILITY 13WA.4TE TIRE <br /> �UNDERUROVNO TANK(MONITORINGWTAOVAL) ❑DOG KENNEL ❑ DAIRY <br /> HA7ARDOUS YIASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑ PUMPER TRUCrJYARDICHEr4 TOILETS <br /> ❑TATTOO/BODY PIrRCING d POOLISPA GLAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILFIY G OTHER(PLEASE SPECIFY) _ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5.QOPM - EK,CLvoiNG HOLIDAYS. <br /> 1. List up to teen 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 addre�: <br /> Indlcated 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 /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review wild be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maxfmusn of five bus�rW* <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that it;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 /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expan=se of the <br /> applicant. f=uture file reviews by the same applicant may require a$93.00 deposit prior to review!. <br /> EHD 47A2.608 <br /> 7l1d(OS <br />