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E�� t r 4 J' p. 1 <br /> Ear^, ATE RECEIVED EHD LOG NUtJ�BER <br /> Is SAN JOAQUIN COUNTY <br /> Ito �6 �[f <br /> r1 Cw(" ENVIRONMENTAL HEALTH DEPARTMENT <br /> M 186S East Hazelton Avenue, Stockton,CA 95205-6232 Fk,R <br /> ENN%rIROft;;rziffAL HEALTH Tete phone: (209)468-3420 Fax: (209)464-0135 Web:wwW.sjgov.o lg/ehd V - f <br /> • S PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY: C'__ <br /> ADDRESS: Z L CITY/STATElZIP: '�OAew.r.e _ _rro!50s� <br /> PHONE (1); 310 2'71$9 PHONE(2): 3(D-3Qy_ $S( FAXORE-MAIL: d301VseC0ASe('✓'F..� •tcw <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN z3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTDATE <br /> 1. List uv to ten addresses in the space below. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to[209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EKD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD Files exist. An appointment for review will be confirmed approximatelyten (10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant, <br /> Future file reviews bythe same applicant may require a 5139 deposit prior to review. <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List ❑ Map-Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> �� USE � � <br /> FILES <br /> 0iZ1 <br /> WI0M1gOUNn TANK NST) Street* Street Name city _ <br /> CLEANuv SITE(LOP) -LOt L,14-17( rfS�(Q Q riuN$YNLII <br /> OTHER CLEANUP SIT.(NON-LOP) - FK'.,. •� <br /> ;KHA RDOUu WM1i (/. e! \\ GI DURA <br /> TIFRFD PFRMITTFC FACILI y �a4- �seeA (�tf J t LIY( <br /> AaOVEOHOUND TANK CCA <br /> UST (INONITORWO I REMOVAL) '/�r T �mv_ <br /> t_2 lAROOU6 MATLHIILL 9 �7 <br /> PIIJJRFIFAr.F RFRrONRP ®'V�ATrR OUAU,y � j2 <br /> ❑SOLID WASTF FA(Yiltt IVFMICI.F A <br /> FOOD rACILITY <br /> POOL./$vA D SnE WICATION <br /> ❑DAIRY 6 <br /> F1 LAND USER LIcmiom SITES <br /> F1 SEPTIC PUMPbK THUM ❑HOUeIND <br /> 6 <br /> YAIpO/rinrMlCa,TOaFTr. <br /> O WAFTFIVATER TREATIAENT PLANT MI61PA <br /> [ IIOU&NO ARSTFMFNT T <br /> ❑MOTF.UNOTEI �/ <br /> 0 CHIM, N RANCH 1000 KFNNFL Ly CUPA-UST <br /> 0 MEDICAL WI T6 FACILITY R <br /> n TATT00/aODy PIFRONC Cl <br /> GODD WAC,E <br /> I]WAsI t TIKk <br /> rl e <br /> rAMIaA1NT <br /> ❑OTHER(PLusc SNL'ory)1 p A=WINO <br /> 10 <br /> ^BOXED AREA-EHO USG tORec=ordsrovided by Staff-PPR Complete- Slav Name: <br /> ENO U-06 <br /> Received Time Sep, 1. 2016 2: 26PM No. 1164 <br />