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JHN-. O-ZUOJ 06:12 PM P.01 -- , DATE RECEIVED;-; EHO LOG NUMBER SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT L'600 East Mehl Street• Stockton. CA 9520'),-3029 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wwwsjgo314? PUBLIC RECORDS RELEASE APPLICATION APPLICANT: RI ' ' BUSINESSIAOENCY: p4ft y ��,(��(r�i, U� f Aye // 6 ADDRESS:_ 2909 �6Ef lPb l2�t" Aldbf?5/i /°a 9,f'Sc.C'" -77-Y, PHONE [11):. _ �i�S"O % PHONE (2): �-y-La__Y�J •.--_pAC81MItE: _- %7'�I/Cf TENTATIVE' APPOINTMENT DATE: Time (Plea## allow 10 6ualn9aa da om date of application submittal - •tentagvc only - must be Confirmed) CHECK BOX TO EXPEDITE- f D F E ( ASH OR CHECK ONLY) • REQUEST PROCESSED IN 3 SINES DAYS REQUES SIGNATURE OF APPLICANT _._._ DATE B '30 O$ epauivu; vale mange of Information Requested: From ..___... _ to y,/ ENVIRONMENTAL HEALTH DEPARTMENT FILES �y UNOE"OUND TANK NOT) CLEANUP SITE (LOP) O HOUSING ABATEMENT ❑�. V-• ' I SDLID WASTE FACIuriNENICLE Q f OTHER CLEANUP SITE (HON -LAP) ❑ DOG ri C3 WASTE WASTE TIRE �UNOERORWNDTANK (MONITORINO1REMpyAL)✓ ❑DOG KENNEL O 1 -'T -'p y/a�0 AIRY ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT O TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑PUMPER 7RUCK/YAROICHEM TOILETS M TATTOOIBOOY PIERCING OPOOLISPA ❑ LAND USE APPLICATION SITES O MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFYL WELL ANO SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW - MONDAY -FRIDAY Ii AM-S:DDPM - EXCLUMNO HOLIDAYS. 1. List up to fen addresses in the spec# above. Select the types) of files from the list above by checking the appropriate box(es). At least Dna ills type MUST be selected. Foto 12081484-0158 or mall I21bo addresa Indio above Address ranges will not be aceapmd — for additional assistance with fila addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be hold for a maximum of five business days for review. Appointments should be scheduled accordingly, 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A now application may be submitted when the file Is available. 4. Any file hot returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant, Future fila reviews by the same applicant may require a $88.00 deposit prior to review. EHD USE ONLY E..-. __ ..------.___. .. .----._-....... _ ays/or '�P'V z�usr� ©I,il to�IcUi;. k� Haz whsle file, CWA;1049/0 "fT re99k-5),M Electronic Information: ❑ Llst U Map- Description: ......_ Clty _.. ..... 4. Street! — _ -_... ._ .. ADDRESS ........_ Street Nama / EHD USE ONLY ------.__. ... _._.___._....._..._�.. .------ El Unit 1 O Unit2 Unity S• 10, unit S unit ii epauivu; vale mange of Information Requested: From ..___... _ to y,/ ENVIRONMENTAL HEALTH DEPARTMENT FILES �y UNOE"OUND TANK NOT) CLEANUP SITE (LOP) O HOUSING ABATEMENT ❑�. V-• ' I SDLID WASTE FACIuriNENICLE Q f OTHER CLEANUP SITE (HON -LAP) ❑ DOG ri C3 WASTE WASTE TIRE �UNOERORWNDTANK (MONITORINO1REMpyAL)✓ ❑DOG KENNEL O 1 -'T -'p y/a�0 AIRY ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT O TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑PUMPER 7RUCK/YAROICHEM TOILETS M TATTOOIBOOY PIERCING OPOOLISPA ❑ LAND USE APPLICATION SITES O MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFYL WELL ANO SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW - MONDAY -FRIDAY Ii AM-S:DDPM - EXCLUMNO HOLIDAYS. 1. List up to fen addresses in the spec# above. Select the types) of files from the list above by checking the appropriate box(es). At least Dna ills type MUST be selected. Foto 12081484-0158 or mall I21bo addresa Indio above Address ranges will not be aceapmd — for additional assistance with fila addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be hold for a maximum of five business days for review. Appointments should be scheduled accordingly, 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A now application may be submitted when the file Is available. 4. Any file hot returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant, Future fila reviews by the same applicant may require a $88.00 deposit prior to review. EHD USE ONLY E..-. __ ..------.___. .. .----._-....... _ ays/or '�P'V z�usr� ©I,il to�IcUi;. k� Haz whsle file, CWA;1049/0 "fT re99k-5),M