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03/07/2013 12:02 FAX 805 964 OL URS Corp Santa Barbara In 0001/0001 <br /> ■ <br /> ■ <br /> ■ DATE RECEIVED EHD LOG NUMBER <br /> ■ <br /> SAN JOAQUIN COUNTY <br /> '■ e`', ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazefton Avenue, Stockton, CA 95205-6232 <br /> �T61lephone: (209)468-3420 Fax: (209)4640138 Web: www.sjgov.org/ehd <br /> 'VPUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT' jo <br /> BUSINESSIAGENCY: V 11- <br /> ADDRESS1�0 Rt/f3(N WILLJ�)t�, "' OU CITY/STATEIaP: - AI'� � • ,(�l� <br /> PHONE(1):CLOS) � PH»f�E(2)! rf X fe c)0 � 40 000FACSIMILE: q3 0 7 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUES $125 FEE CA),H <br /> H OR ONLY)-REQUEST PROCESSED IN 3 BUSIN�SS�AYS <br /> SIGNATURE OF APPLICANT DATE Z� 7//3 <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1 % ElUnit 1 <br /> 1. �. L( DL�D s N Z�t 2. I��� i�f �(_�lt z<1�► Ir,r j �4 , coiv <br /> fUr J ;3 �'7 � ❑Unit 2 "n <br /> 3. ' ✓ 1 <br /> 4. <br /> �Unit S <br /> 5. — To view the HMMP (Hazardous <br /> 6. Materials Management Plan)go to the ❑/6nit 4 <br /> 7. following website: www.sjoesdata.org <br /> 8. ❑Unit 5 <br /> 9. <br /> 10. <br /> ❑Unit s <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHIC/LE <br /> z ' <br /> 41HER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT WASTE TIRE f y�(�S I1)'- <br /> [� F] E]ERGROUND TANK(MONITORINGIREMOVAL)� ❑FOOD FACILITY ❑DAIRY -13- <br /> OVEGROUND TANK G C. ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> L AZARDOUS WASTEIHAZARDOUS MATERIALS V� ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑PpOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATT00113ODY PIERCING OMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file tvDe MUST be selected. Fax to(2091 dsa-M za above. Address <br /> ranges will not be a I c�q ��C �� �� �/]/�L�eli�!/S��i I�5 . received after <br /> 3:00 pm will be prosrw <br /> 2. The EHD will notify �1Cf II�i9 iv aSl;q o3�1L/LyQ in Ju%.!5 11k mimatelyten(10) <br /> days after receipt o --r---T-*--r 3pointments <br /> should bet <br /> s activ 1, �qq 11 3 1(0113 aq S�� 31�D`7q d35i�fg <br /> 3. A file that is activel� � � - optication maybe <br /> submitted when the �}�{ �j Q� <br /> 4. Any file not returne �' t� ' ° 'I S Pf I�U "-, �s E� -- the applicant. <br /> Future file reviews I -EHD USE ONLY— <br /> �64�X 5.01326, x55— 106 >><5J 0110851 5-��gql <br /> x / -�o2az <br /> Y,6-T-0243-4' <br /> X55 -03Aq-7 03 52s',4x5--')-03541-7 <br /> Rece�ved Time Mar. 1. 2013 11 :54AM No. 2511 �`I�-1 �` Plea( <br />