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■ _ <br /> Jul- 08.2014 01:49 PM U�,S Long Beach 56267905 PAGE. 1/ <br /> io <br /> DATE RECEIVED SAN aIOAQUIN COUNTY (CIE <br /> ENVIRONMENTAL HEALTId DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209) 468.3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:� BUSINESS/AGENCY: Caf tr._6n <br /> ADDRESS: 31'0 L_ -�,�\C_ V�0 CITYISTATE/XIP: r\ Cyt' RoBOZ <br /> PHONE(1): D��A 9 PHONE(2):, FACSIMI E:5AdL.- to?1- <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Pleeso allow 10 bualness days fro data of application submittal�'Tamfit re only-must be confirmed) <br /> F1 CHECK BOX TO EXPEDITE REQ T.$12 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE -VIM 1 q <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHO USE ONLY <br /> ._1'...^.. _——...•_......_..__.._..__. Street Name City_ <br /> .. Street# ._ _,.... ._ <br /> Nl liLIST N6�' <br /> to5� N �p,.•tw� , � L � <br /> 2. - Unit 2 <br /> 3. <br /> L�� .�. _.... -.'. -- - ---------------''-- ---------•---"_--._".---- unit$ <br /> 8. ❑Unit s <br /> 10. ❑Unit e <br /> 9poclflc Date Range of Informatlon Roquastod: From 1110 1 to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE 14 <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE ) L� <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY Lf tlf?3 <br /> RHAZARDOUS WASTE GENERATOR ' El CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT7Z7- /C/ <br /> TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS n�J� <br /> TATTOO/BODY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> IJ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPEurY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILA13LE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. Llat up to ton addreasas 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 fllas 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 conditlon 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$122 deposit prior to review. <br /> ENO Wa ONLY ' <br /> 1` <br /> EHD 49-0e 07125110 <br /> Received Time Jul. 8. 2014 1 : 57PM No. 6521 <br />