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r3: 'rage3OT3 2014-08-21 18:14:25 E51- 1 y1 byb226/ti From: Lily Muller <br /> t <br /> RE EA� <br /> DA �� Q <br /> � SAN JaAavlN COUNTY (Dfly: <br /> AUG 2 '�1.4 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIR0NMEIVTAJ&p"ne: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 41 <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: % torC �- sV.rUZIS BUSINESSIAGENCY: C�'jc�✓'� y1 C� <br /> AADDRESS: 157J-� pp l r.n114,05c De CITY/SrATEIZIP: 13C, <br /> PHONE(1): j11v ROS 93(VO PHONE(2):, �O<, 1 ] FACSIMILE: �1�1c�s�t1Pf��f.�svx <br /> Please allow 10 business days from date of application submittal for the records to be available, <br /> Staff will contact you to arrange an appointment date and time to review the requested records. . <br /> ❑CHECK BOX TO EXPEDITEREQ]UI=ST 5 25K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE- 1 1 tom, <br /> Electronic Information: , ❑ List❑ Map—Description: <br /> -71 <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city tJnit 1 <br /> 0—v-�e � ADI'l �� (M r�GCG� <br /> 2. ( LI ��� ," <br /> I Unit <br /> 4' Unit 3 <br /> LI U, <br /> 'it <br /> 7. <br /> a. -- <br /> �' Units <br /> 10. <br /> C�u�,it s <br /> Specific Date Range of Information Requested. From c,, r to r __ <br /> ENVIRONMENTAL HEALL H DEPARTMENT FILES <br /> XUNDERGROUND TANK(UST)CLEANUP SITE(LOP) V MEDICAL WASTE FACILITYSOLID WASTE FACILITYNEHICLE I� � <br /> BOTHER CLEANUP SITE(NoN-LOP) HausING ASATEMEKT ,WASTE MILE J Y <br /> OUNDERGROUNDTANK(MoNITORINGIREMOYAL) F0013 FACILITY CKDAIRY <br /> A9UVEGROUND TANK CHICKEN RANCHI DOG KENNEL WASTEWATER TREAT&TEi47 PLANT <br /> HAZARDouswArrEIHAZAADOUSMATERIAL9 ❑MOTELIHOTELPUMPER TRUCKNARDICHEMICALTOILETS <br /> TIERED PERMITTED FACILITY POOLISPA j2LAND USE APPLICATION SrTES <br /> ❑TATToomooy PIERCING COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FoR REVIEW: MONDAY-FsIDAY 0:00 ATN-5:00PM(EXCLUDING HOLIDAY$) <br /> 1. List u0 te_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[a-(204).,464-0138 or mail to the address indicated etbove.- Address <br /> ranges will not be accepted.Applications received atter 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHO records,please contact EHD at the number noted alcove. <br /> 3. The EHD will notify the applicant ii any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The fires 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 isle reviews by the same applicant may require a$125 deposit print to review, •"EQKiAD AREA-EHD USE ONLY'*` <br /> © Records provided by Staff-PPR Complete. staff Name: <br /> //1410 4s-06 4128/34 <br /> Received Time Aug. 9 . 2014 4: 14PM No. 68$7 _--'? <br /> ._ <br />