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®® 04/04/2016 MON 12:49 FAX 0001/001 <br />em <br />m <br />em <br />■ <br />t ® DPTICENEU <br />EIVED EHD LOG NUMSER <br />tmm SAN JOAQUINl COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT V- <br />1668 <br />3 1668 East Hazelton Avenue, Stockton, CA 95205-6232 ` ) <br />PR 0 4 2'6lephone: (209) 466-3420 Fax; (209) 464-0138 !Blab: www.sjgov.org/ehd <br />ENVIRONMENTAL HEALTj.i; <br />QEF IT1SE€ 1 '''PUBLIC RECCRDSO RELEASE APPLICATION <br />APPLICANT: Lyla Gray-Etherson BUSINESS/AGENCY: Property Solutions Inc <br />ADDRESS: 323 New Albany Road CITY/STATEIZIP: Moorestown, N1 08057 <br />PHONE (1): 856-813-3000 ext245 PRONE (2): FACSIMILE: 856-813-1073 <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - "Tentat/ve only - muet be eonflrmed) <br />❑ CHECK BOX TO EXPEDITE REQUES $125F (CA�4 OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF A.PPLICAN7 T ELATE <br />Electronic Information: ❑ List ❑ r ®p — escrlptlon: <br />FILE ADDRESS <br />FHD USE ONLY <br />Utslt 1 <br />street!! <br />Street Name <br />City <br />I ,s- <br />.�e,j C LA Nif, <br />6 ' �c� /t2 <br />r2. <br />L� s(2 <br />ra 0e ,�� <br />s' a <br />3. <br />nit 3 <br />4. <br />5. <br />9. <br />D Unit S <br />-u-u"r a <br />t�. <br />10. <br />Spaciflc Qat® Range of Information Rsqueated: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) [IHOUSING ABATEMENT ❑ SOLID WASTE FACILITYNEHICLE <br />UX OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE <br />® UNDERGROUND TANK (MONITOR(NG/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br />❑X HAZARDOUS WASTE GENERATOR`(F✓,✓✓ Nja L]CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCKNARD/CHEMICAL TOILETS <br />❑ TATTOO/6ODY PIERCING ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br />❑ MEDICAL !HASTE FACILITY ❑ COMPLAINT RECORD5 ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (ExCLUDING HOLIDAYS) <br />1. List up to ten addresses In the apace above. Select the type(s) of files from the fist above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax-ta(2Q91464.0138 ormall to the address Indicated above. Address <br />ranges wllr 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 EI I] files exist. An appolntment for review: will be confirmed approximately ton (10) <br />days after receipt of appllcatlon. 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 flle reviews by the $"ne�,ppllc�t may.requlre a S126 deposit prior to review, <br />FHo 46-G8 <br />Received Time Apr. 4, 2016 10:48AM No.0655 <br />-A) <br />; l -i6" <br />