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DATE R <br /> s�o�oommwosn <br /> ���\0 ����O|� ��{�0N-�w�� � � e��m mm=���u�"NED <br /> --' `="� °= ^a <br /> EyJV/RK3088EMTAL U�E^�L��� DEPARTMENT <br /> ' ' ~~ ^^ <br /> �� �01- 18G9East Hazelton Avanue..Stockton, CA852O5-8233 <br /> NOV� Telephone: (208) 468'3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMEMTALHEALTH PUBLIC RECORDS RE-LEASE APPLICATION <br /> APPLICANT:' BUSINESS'/AGENCY: <br /> PHONE (1): PHONE (2): FACSIMILE: <br /> Please allow 10business days from date ofapplication submittal for the records bzbuavailable. <br /> � <br /> Staff.will contact you to arrange an appointment date and time to review the requested records. <br /> CHECK BOX ToEXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: El List El Map—Description' <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City <br /> 61 Y-eli <br /> 3. <br /> 5. <br /> 11w,__,5�-L_ )" <br /> KV6_1TE MITIGATION <br /> "71 ,55 :5 ic 61.-L 61j',f le 5 (,AA S,to 6 K 'it X3 <br /> Specific Date Range of Information Requ6sted-.1 From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> R UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0,MEDICAL WASTE FACILITY nX SOLID WASTE FACILITYIVEHICLE <br /> WASTE TIRE <br /> nX OTHER CLEANUP SITE(NON-LOP) &HOUSING A13ATEMENT <br /> MUNDERGROUND TANK(MONITORING/REMOVAL)�— 0 FOOD FACILITY- DAIRY jl�,, Ltol I IV <br /> -1 CHICKEN RANCHI DOG KENNEL TREATMENT PLANT <br /> WHAZARDOUS WASTEMAZARDOUS MATERIALS F-1 MOTEL/HOTEL PI-PUMPER TRUCKNARDICHEMICAL TOILETS <br /> 91 TIERED PERMITTED FACILITY POOLISPA Z-1,1.LAND USE APPLICATION SITES <br /> 4 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:OOPM(EXCLUDING HOLIDAYS) <br /> priate <br /> `' List up to ten addresses in the`~~~-above. SelFax to(209)464-0138 or mail to the address indicated above.ect the ~---' of filesAddress6vx�s . xu|e�tone�|*�pe MUST bosa|o�eu. <br /> ranges will not baaccepted.Applications received after x:oupmwill oeprocessed uthe next business day. <br /> u. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> o. The EHowill notify the applicant ifany EHofiles exist. Anappointment for review will boconfirmed app,oximate;yten(1u) <br /> days after receipt.ofapplication. The files will beheld for amaximum offive business days for review. Appointments <br /> should boscheduled accordingly. <br /> 4 Any file not returned in the same conditi.on as released will be reorganized by EHD staff at the expense of the applicant. <br />