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NOV-19-2014 WED 02;21 PM KLEINFELDER FAX N0. 8012613306 , <br /> PEDE:� <br /> DATE RECEIVED <br /> EHD LOG NUMBERNOV l au ZU►u SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �� ' <br /> pi,_RMil,--i\/76T9'phone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; r�o.�� i, P�Q� SUSINESSiAGENCY:�r�f�.FCra62 <br /> ADDRESS: o, Q o CITY/STATEIZIP: {cr GaCE c�TY/yy"/ 3 <br /> PHONE(1): g�Lz PHONE (2): -7it zSGf.?> FACSIMILE: <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 /> Q CHECK BOX TO EXPEDITE REQUEST-S130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3[3USINESS DAYS <br /> SIGNATURE OF APPLICANT A Fr,-e DATE--/// /7/Ze,)`1 <br /> Electronic Information: ❑ List* Map—Description: rw <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Namo City 71 Unit 1_ <br /> 2' Yo ,tJ -TQ�G� ✓� 5-- <br /> Ae- M USi ` llnit 2 1 <br /> 3• yz7G �e TQa�'� <br /> 4. 4 CoQ ;`�' Q.dG /% unit. <br /> Co <br /> o QA TQ'4 iq <br /> () TQ��� v Q G� U5T C�ne{or t tom`�S i Unit 47 8,A / <br /> 7. t,A2L}1 kb "TQ,RC M u5f leer kd1 <br /> D c, 3 Unit 5 \ ` <br /> 9. <br /> 10, <br /> z unit 6 <br /> Specific Date Range of Information Roquested: From /�c/D to r,_e 2E 1J'V ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TiRE <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) 0 FOOD FACILITY ❑DAIRY <br /> +�ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ®WASTEWATER TREATMENT PLANT ate" <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS []MOTELIHOTEL ❑PUMPER TRUCKiYARD/CHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY ❑POOLISPA LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ®COMPLA[NT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND 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 he selected. Fax to 209 464-0138 or mail to the ad ss 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 EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD flies 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 /> 4. Any file not returned in the same condition as released will he reorganized by EMD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. "'BOXEDAREA-EHD USE ONLY' <br /> (, ivtl. 7 <br /> a 1cJ (C r ch.. P ctkc( U {� cit' ,' �a7� 1.z c• An1��car� C:ziS►c- I c �'C�ue ) i/S <br /> ^ -r — PJAP, ti <br /> 4ot=711 C" IEtic� ('t3,t>wn_'7uc• ,r Ped,ded LA/17 ! tj&+' <br /> MJ <br /> ' i�c i.- c: k��i� i�45dg u✓f3� Ci oif?t4 f�,� NiJ Cile ovii`IO � <br /> rc,cc <br /> BHP 4e-06 091o�na <br /> cow-a �� -3q.40T cy('Tnzcy ztc�t Auto stcp) o�p rn I!-✓j •PiLe, P,ry d tctt.r-c b:�ac1 do cra" � <br /> Received Tim Novi19. 2 14 1 : 34PM N , ]5 4 �fl�ta4rz .in �� C��S:ruc1`wa 3g4o)Mc�s P;bVc-94 <br /> 1k��,raryT2lck�Au alb 1)T^ctu�4-il� C:A 37�1� i/Ytc�J(u5T r�95ka�� l <br /> '�i!(� .Zcy (fl�f resiufl. U5T) zo,,7Ei C 'rcI Hoilo4z Cifv5), tet' <br />