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' RE 1D5RM HP LRSERJET FRX " <br /> Nftl� biAN JOAQUIN UOUNTY <br /> ✓',F:� 3 1.2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> a ww600 East Maln St. Stockton, CA 95202-3029 f _ <br /> ENVIRONMEs RVI HJA4jHhona: (209) 468.3420 Fax: (209) 484.0138 Wab: vv .sjgov.org/ehdPERMIT \Wfl <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 7�b 1`-IJ�-VA--i,4 Tvw1 EIUSINESSIAGENCY: <br /> ADDRESS: BasIcs Environmental, Inc. CITYISTATEIZIP: <br /> , u e PHONE(2 <br /> PHONE(1): U519 12th res ): 510 f6 cl 091 FACSIMILE: 90 Vs-f-%'9 b <br /> TENTATIVE"APPOINTMENT DATE: 6^'9 —1 1 Time: <br /> (Pleose allow 1abuelrafe rotn dobe of application subminal-'Tentative only-must be confirmadl <br /> ❑CHECK BOX TO EXPEDITE R 3T 12s F E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 5/LI/)I <br /> Electronic information: ❑ LIW❑ M p Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Streets street Name City L;gknit t <br /> &S, Am c0/5 <br /> 2. <br /> Unit <br /> 3. <br /> 4. <br /> unle i <br /> 5. <br /> 6' unn 4 <br /> 7. <br /> S. <br /> Z3Unitb <br /> 9. <br /> 10. <br /> nit 0 <br /> Specific Dote Range of information Requested: From to <br /> ,- <br /> -,,{ ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> G2 NDERGROUNDTANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT f� <br /> rW-�a•7•.r ,L�J,G��'^'0 WASTE FACILITYNEHICLE <br /> HER CLEANUP SITE El FACILITY LaWASTE TIRE <br /> CWNDERGROJND TANK I MONITORINOIREMOVAIP �D00 KENNEL DAIRY 6..�_O <br /> [IMICIARDOUS WASTE GENERA DRQ CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYAP.WCHEMICAL TOILETS <br /> ❑TATTOCIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FR(DAY 8:00 AM-6:OOPM(EXCLUDING HOLIDAYS) <br /> 1. Llat un to ton addresses In the apace above. Select the type(s) of Ales from the list above by checking the appropriate <br /> box(es). At least one RIe type MUST be selected, Fax to 12091484-0138 or mall to the addMits Indicated above Address <br /> range*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 flies exist. An appclntmont for review will be confirmed approximately ter (10) <br /> days after recelpt of application. The Ries 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 now application may be <br /> submitted when the file Is avafleble. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expanse of the applicant. <br /> Future Rle reviews by the same applicant may require a$122 deposit prior to review. <br /> Se ONLY <br /> mHD 4641 <br /> 07 pe/1a <br />