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From:Terracon 916 956 6277 06/26/2013 11 :19 &093 P.0011001 <br /> ■ F�-llMa�N19n1kPoN E� EHD LOG NUMBER <br /> L_� CG-V L-H-CJ LLL��� SAN JOAQUIN COUNTY <br /> AUG 2 6 2013 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd �� <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: (�Ik < <ja,� BUSINESS/AGENCY: `Te,-�4,_c, <br /> ADDRESS: 2 /L/rj .Ia(.(?*,"p 76) CITY/STATE/ZIP: Z"C4/ Cor. ✓a C� 4lC7e <br /> PHONE(1): &14> PHONE (2): FACSIMILE:A/4 BSB- 82-7 <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 REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> �vFILE ADDRESS EHD USE ONLY <br /> Street# Street Name city El <br /> Unrt 1 <br /> ✓✓ 1• lore i= 1 l�.-.�.« c4��� !cam //,hi ,' �. <br /> o �NU /�4P QUf11�j <br /> HT14 2. 7m z L/4,..,,.�i. La,.+i ��,oa � 'T � 1 Unrt2 <br /> 3 2 8 • IJXL r dr L4A'- .L IG.-I-or� yu�(Ill I k 3��, L(Jii 13d7/Gl <br /> 4' <br /> E. ick l-are of /_ 01115 unHs <br /> ✓ 6• ms E, 94'.0100. L-°...t: .t t+ -/ocY�•�'n Nc�d� /VO c.Gt'` C�l""(,J <br /> 6• 34d/S /Lw.e r L o.✓ e N units <br /> 1d o <br /> t/ T. 3 /� rJ �n Ewa , to/�) <br /> 8. Sloe k4.) Aj0 LCIS Y ❑Un � <br /> 9. 773a /A"..r _R_,4 _ �o M /. 1 /w <br /> di 10. ❑ Unite <br /> -P Specific Date Range of Information Requested: From to <br /> �r-��� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> -UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FA IL NEHIC ,' ^ <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE 12 i(9%r l^�' <br /> UNDERGROUND TANK(MONITORINGIREMOVAL)1 - ❑FOOD FACILITY ❑DAIRY �q-II-13 <br /> ABOVEGROUND TANK vZ [:)CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS CX- ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE.SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. 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)464-0138 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. i <br /> 2. 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 /> 3. 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 /> 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$125 deposit prior to review: —BOXED AREA-EHD USE ONLY-- <br /> c' -EHD USE ONLY-- <br /> ..., .. .r,., . . <br /> E-RecoTds-Kolridedby-Sta -PP_R-Complete.-start ame: a(U-.iL ;QVt <br /> EHD4a46 Qru/t'�- OlcC�(/tRr00/l1/_tui�lf'S. [-� stau <br /> Received Time Aug, 26. 2013 11 : 13AM No. 3923 € <br />