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�M�c 11 12 06:01p Lee & Pierce, Inc. 2098488274 <br />:ATE e-�cIVffD <br />SAN JOAQUIN COUNTY <br />I: ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />1 '- <br />D�C $ A�Iephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLicxnON <br />P.1 <br />EHD LOG NUMBER <br />�-A�, .. \, I„— <br />APPLICR�: JD�� ��BUSINESSIAGENCY: Lee I, } <br />f(`'��"`� f Iy\g, <br />ADDRESS: `3�� S. �uS� ��� 5-J'2 AT CITYISTATEIZIP: 0�kInt c'V_ l !a_� <br />PHONE (1): 20 '612(1 S;�70 PHONE (2): -a) `j`��� S�IZ FACSIMILE: 2e <br />TENTATIVE* APPOINTMENT DATE: , 5A> Time: <br />(Please allow 10 business days from dale of application submittal -''Tentative only --must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUESLF$125 E (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUST ES DAYS <br />SIGNATURE OF APPLICANT �U —��— DATE RZ 1 ( Z <br />Electronic Information: ❑ List ❑ Map —Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />❑ Unit 1 <br />Street # <br />Street Name <br />City <br />3 <br />4. <br />i S <br />q q -1 <br />cpr-'Z' <br />LL_* <br />t� <br />J' AAA ❑Unit 3 <br />5. <br />CC�II\`O' <br />Unit d <br />o <br />6. <br />�'� <br />e N . F. F. (� <br />7. <br />j 20 <br />�ti A �% <br />L�rP i� <br />To view the HMMP (Hazardous <br />ElUnit 5 <br />p unit s <br />8. <br />9- <br />10. <br />Specific Date Range of Information Requested: From Materials Management Plan) go to the <br />ENVIRONMENTAL HEALTH DEP) following website: www.sjoesdata.org <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FAC :HICLLE jj �jjr <br />MOTHER CLEANUP SITE (NON -LOP) E] HOUSING ABATEMENT <br />UNDERGROUNDTANK(MONITORINGIREMDVAL),,,,z_ ❑FOOD FACILITY ❑DAIRY <br />ABOVEGROUND TANK c�<_ ❑ CHICKEN RANCHI COG KENNEL E�fI(IIASTEWATERTREATMENT PLANT <br />HAZARDOUS WASTEIHAZARDOUS MATER1ALSo/- ❑ MOTELIHOTEL ❑ PUMPER TRucK1YARDICHEMICAL TOILETS <br />TIERED PERMITTED FACILITY ix OOLISPA ❑ LAND USE APPLICATION SITES <br />TATTOO/BODY PIERCING COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00Pt.1 (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 EFID. 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. **"bbXED AREA- EHD US ONLY <br />Z"Z i V �' C(Donc)y� J <br />61W te4jaX-.:--7- 0 "7Ci r (- i <br />Il-2��I qM 7 �. 3i <br />Received Time Dec.11. 201 5:02PM No. 835 <br />r) <br /><w <br />