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FromAarcus H. Bole & Associates 530+633+0119 10/23/2012 15:21 #257 P.001 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN AL H COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT �t <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION d <br /> APPLICANT: 2 n e BUSINESS/AGENCY: Role t- /1�Sryir� C �y <br /> ADDRESS: (I?-1�1yt'-o.K_ OCL CITY/STATE013: C� <br /> .7 <br /> PHONE(1): J I57 &6pt3 PHONE y3O bD 2;, d)l FACSIMILE: 53063,3 6/M <br /> TENTATIVE'APPOINTMENT DATE: ifs Srrvl as Fi�rs�ic avail( Time: Mit( <br /> (Please allow 10 business days from dAte of application au lrttal.-Tentative only•must be e'on ` .d] <br /> ❑CHECK BOX TO EXPEDITE REQU $1 E%jC�SH�O j.CHECK ONLY)-REQUEST PROCESSED IN 3 BUST ESS DAYS l <br /> SIGNATURE OF APPLICANT =,cry JSP DATE O d� <br /> a12�11 Electroniclnformation: ❑List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City 171 <br /> unit'" <br /> 2u� 1• -141�3 lrl llini' lD r 0 l'l _ ! i <br /> r(� Z. 6nil2 <br /> -Al 11i7 '� n113 / <br /> 6. <br /> Unit 4 <br /> 7. <br /> e. <br /> Unit 5 <br /> Ulu <br /> 9. <br /> i <br /> 10. _aunit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ITHER <br /> RGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑STOLID WASTE FACIUTYIVEHICLE r <br /> CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT j� JASTE TIRE -7 .6ItjG> W-tv, 3. <br /> RGROUND TANK(MONITORING/REMOVAL)^ ❑FOOD FACILITY ❑DAIRY �3�mn 1ry1- I(_CJ.(Z <br /> EGROUND TANK p/, ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT YLAM . <br /> RDOU$WASTE/HAZARDOUS MATERIAL ❑MOTEUHOTEL ❑PUMPER TRUCKIYARD/CHEMICALTOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ElLAND USE APPUcATwN SITES <br /> E]TATTOO/BODY PIERCING OMPIAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 A A-S:OOPM(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(2091464-0138 or mall 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 /> 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. WO�T7�___TAX N <br /> NORRIC <br /> . ' <br /> rGCR1�a",.� z <br /> EHD 46.96 9N/t2 <br /> Received Time Oct. 23. 2012 3:31PM No. 1474 <br />