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DKMAAt1Vt:U SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB 0 8 201? 1868 East Hazelton Avenue, Stockton. CA 95205-6232 <br /> MANtONMENTALWMTH Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd 5515 <br /> PEMMMMEMAM . PUBLIC RECORDS RELEASE APPLICATION <br /> *APPLICANT: jaw& John&�bo BUSINESS/AGENCY: 'FF�c &IDWA <br /> ADDRESS: balei waf -TiI Rfati CITY/STATE/ZIP: Lim A­nA-Mof, C4 q0t)Y9 <br /> PHONE(1): (�10) B13q-�300 PHbNE (2 : (3j0)89q-0jqqe-_&AX RE-MAIL: igrne.5—jaAri&�MFEFC <br /> the records to bd avallabld. to", tll-m <br /> Please allow 10 business days from date of application submittal fort e ri <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> 1. List up to ten addresses in the space below. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. 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 /> 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 same applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic information: 0 List F] Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> UNDERGROUND TMK(UST) Street# Street Name City <br /> CUEANUPSaE ILOP) <br /> ­1:jtAJ CONSUMER <br /> jK0UHERCLEANuPSrE(NON-1_0 I i �Ooo E Hwy BB Loql_e4'� <br /> RL HAZARDOUS VVMTE �') — <br /> IERED PERMU�EC FACIU 2 <br /> IRT <br /> ABOVEGROUNDTANK 4, <br /> UST (MONITORING/REMOVAL) El PAS <br /> HAZARDOUS MATERIALS <br /> gSPILLIRELEASE RESPONSE <br /> E]SOLID WMTE FACIUW/VEHICLE 4 V [VWATERQVAU1 <br /> r-1 FOOD FACILU� — j4 <br /> F-1 POOL/SPA E.MITIGAnON <br /> nDARY <br /> LAND USE APPUcATION SUES <br /> SEPTIC PUMPER TRUCK/ 6 E]HOUSING <br /> YARD I CHEMicAI_TOILETS <br /> WASTEWATERTREATMENT PLANT CUPA <br /> F-I HOUSINGAEATEMENT 7 <br /> r-1 MO�UI­CffEL <br /> [-]CHICKEN RANCH/DOG KENNEL +::f= - rT t,_"cuPA-usT <br /> F-1 MEDICAL WASME FACIUW C , I t+m <br /> TATPOWBODY PIERCING Z,.r []SOUD WASTE <br /> W�TIRE <br /> t�;50MPLAIW <br /> 0UHER(PUEASE SPECIFY): E]Accot.wiNG <br /> "elt/Af Ho 10 <br /> AN -BOXED AREA EHD USE ONLY* <br /> A�C- cin-f G��;a _RU(17 <br /> ecords provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br />