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OCT --16-2013 WED 09;59 AM Moore Twining Associates FAX NO, 559 268 7126 P. 02 <br />l <br />i) SAN JOAQUIN COUNTY EHD Loc NUMBER �. <br />Ob - � <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />OCT 1 2013 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />ENVIRONMENTAL HEALTH � <br />PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: `P�.:I;p M����ez BUSINESS/AGENCY: I'1 co re Tt.: r%,%.% <br />ADDRESS: 252-7 Fr-eK �v S-i--ee- -- CITY/STATEIZIP: I .eso G <1 9 3-7Z.t <br />PHONE (1): PHONE q78--75e4I FACSIMILE. (SsQ) zGR- -7I2 6 <br />TENTATIVE* APPOINTMENT DATE: /c, 12 5- /3 Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only- must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE DATE jo/is�/3 <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 />1,110 ( <br />Lever j3c,..fevw 2 �� <br />S+��a�., <br />nuc ci2it� /.kcc�p..i�u 3 <br />t� urui�jD�rocc�s u.uF'� ,(] Unit2 <br />2• <br />t l L4 <br />(ewer move✓z�rc� iV l� <br />S Ix�}ah <br />3. <br />-2-72-5 <br />Y� ; Cl : A, A ✓�.,. c <br />S4ey_L -low <br />Nn uvu� lxco Unr�'S <br />�o-fDb Nc cct Unit 3 <br />4. <br />J <br />Unit <br />6. <br />(-72-(rr,Itr <br />7. <br />I S <br />CfOwn fieri. t �/ <br />s� }v �� <br />(la u�ut �Vlccc �p moi. ii 3 <br />A:, Luu&391NoccsP,kr7&3 ❑Unit <br />8 <br />aLO l <br />E• F(er" AL -1-1- <br />9. <br />7 d l <br />4n[ 4�.4C,,, <br />nu u.ul IJccc ,p uUut 3 <br />ai�11Lh3 Q -Units <br />10. <br />12 <br />v.+ .,, <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />6h- [✓rUNDERGROuND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY [� SOLID WASTE FACILITYNEHICLE I �� <br />V ^ [ZOTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE,' <br />n [UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY DAIRY <br />fABOVEGROUND TANK ❑ CHICKEN RANCHI DOG KENNEL PWASTEWATER TREATMENT PLANT ) <br />�1 [HAZARDOUS WASTEIHAZARDOUSMATERIALS ❑MOTELIHOTEL❑ PUMPER TRUCKIYARDICHEMICALTOILETS <br />TIERED PERMITTED FACILITY RCOMPLAINT/RESPONsE <br />POOLISPA [�/ LAND USEAPPLICATION SITES <br />TATTOO/BODY PIERCING RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (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.....xp.._.eense of the applicant. <br />_.,....._.............. . _......_...... <br />Future file reviews by the same applicant may require a $125 deposit prior to review. "k13b 1Ep: A - EN.R 5.E QNLY. <br />}� <br />.ID 3i l � � � J CLU r.� 1 iCr1/l � u� tic-k//'?„6 }��f �.....:}j-:.::.�.:��'�::;:.:1�>(�:~::� �-:-r: r:;�i::�..:'';=':. <br />EHO 48-06 1 f 8/4/1? <br />Received Time Oct:16. 2013 9:51AM No.4318 <br />