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age: 2 of 2 02/17/2016 03:22 PM TO:12094640138 FROM: Genevieve Enriquez <br />PHONE #5104349200 <br />EHD LOG NUMBER <br />DREELL; ivfz SAN JOAQUIN COUNTY <br />r ENVIRONMENTAL HEALTH DEPARTMENT <br />FEB 100 201q 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />`, elephone: (209) 468-3420 Fax: (209) 464-0138 Web: vwvw.sjgov.org/ehd <br />ENWtM&WrAL HEAL <br />PE OIT/SE g PUBLIC RECORDS RELEASE APPLICATION <br />I@] <br />APPLICANT: T -1, -kw POS& <br />BUSINESS/AGENCY: Mi%16NOW4. S$W% Wlr, K <br />ADDRESS: '\103 t\�6WRZb"ir F-4%NNk ,6, %\I%b CITY/STATE/ZIP: W-k\A\ <br />PHONE (1): Wt' 11M 5Xt Y0'b PHONE (2): FACSIMILE: bk%% tkbq--1y16 <br />TENTATIVE* APPOINTMENT DATE: FroWW► \RA.%% Time: C -%M <br />(Please allow 10 business days from date of application submittal -'`Tentative only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQ - $125 E (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 211=11101(a <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />❑ Unit 1 <br />Street # <br />Street Name <br />City <br />1. <br />3102 <br />5. MK89- LAMS <br />M W <br />k W T , ,^UT r <br />' CO , nit2 <br />2. <br />3. <br />Unit 3 <br />4. <br />5. <br />El Unit 4 <br />6. <br />7. <br />Unit 5 <br />8. <br />9. <br />❑ Unit 6 <br />10. <br />Specific Date Range of Information Requested: From blKwutw4 to roNO <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY ❑ SOLID WASTE FAC,IL�ITTYnYNEHICLE <br />❑ OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE J— CD r 0 tM'"q <br />UNDERGROUND TANK (MONITORING/REMOVAL) ❑ FOOD FACILITY ❑ DAIRY ZS_ (p <br />❑ ABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br />'HAZARDOUS WASTEIHAZARDOUS MATERIALS91,_ ❑ MOTEL/HOTEL ❑ PUMPER TRUCK/YARD/CHEMICAL TOILETS <br />❑ TIERED PERMITTED FACILITY ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOOBOOY PIERCING ❑ COMPLAINT/RESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELLAND 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 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 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 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. O7CEDtE `EFD4aA)L <br />EHD 4"6 <br />Received Time Feb.17. 2016 3:22PM No.0487 <br />