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0 NOV 18 2014 1:07PM THE UPS STORE 2503 916751772 <br />�'� O p <br />1:1111DATE RECEIVED EHD LOCI N ER <br />ie SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT j <br />V. <br />NOV 1 1888 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0136 Web; vwrw.sjgov,orglehd i <br />ENVIRONMENTAL i lE{,GTT ' <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: 1 BUSINESSIAOENCY: ��z -:r- <br />ADDRESS- (p 5 � �, �� p"� �.� � CI <br />TYISTATEIZIP: <br />PHONE (1)1 Lr i fo G� PHONE (2): FAC8IIMIILE ,.3 z_ `i' 2. G <br />TENTATIVE APPOINTMENT DATE: Time: <br />(Please allow 10 busirwss days from aite of apP§cation svbmtttal - `Tenmt/vo on - must bo cortlrmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />DATE <br />EtsctronlcInformation: ❑ Llst ❑ Map- Description: n <br />FILE ADDRESS <br />EHD USE ONLY <br />� Unit I <br />Vega s <br />Street Name <br />Ctty <br />�+t,M V) a;�r crsp <br />, <br />fl S + M i t +M� �''~ Unit 2 <br />/ f%� <br />�� _ <br />$, <br />'tf✓1M � �� <br />Urfit 3 <br />6. <br />'UWt4 <br />6. <br />I' <br />- - <br />- <br />7 <br />units <br />a. <br />Unita <br />14, <br />SPWft D$ft Range of IMormotlon Requested; From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />LW"KIROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDcAL WArsTE FAcury ❑ SOLID WASTE FA0ILITY1VEIi1CL1= <br />OTtM CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE _ �l3 <br />w (1MONrTORNWREatovAL) ❑ FOOD FACt.I?Y ❑ DARY <br />A80'rBBROU�ID TAKesel- <br />❑ Cf#CKPN RAWW Doe KF eel- ❑ WAmwAIERTREATMENT PLANT <br />fIAtSMA WASWHAZARDOUS MAT8I ALS ❑ WOTELhiOTEL ❑ PUMPER TRUCKIYARDICHEMCAI. TOWS <br />❑ TIMED PmdmF.D FACILITY ❑ PODVSPA ❑ LANO USE APPLICATION SITES <br />❑ TATToW3oDY PIeww ❑ COW- AWMtESPOM RECORDS ❑ O'THER (PLEASE SPECIFY) <br />WELLAND SEPTIC PERMIT RECORDS ARE AVA i-AaLE rCoR RENiEw: MONDAY -FRIDAY 8:00 AIN-5;00PMEXCLUDING HOLIDAYS) <br />1, Lost UR to ten sddrassee In the apace above, Select the type(s) of files from the lest above by checking the appropriate <br />bo*ee} At least one file type MUST be selected. Fac to 12M 46"138 or mpg to the addrm Indiodod above Acidnalm <br />raRgas will not be accepted - for additional asalsbave with file addresses, contact the EHD. Applications received after <br />3:00 pm will be process" the next buslness day. <br />2. Tto EHD will notify the applkant H any EHb files exist An appolnonent for review will bo confirmed approzlmataly terk (10) <br />days atter receipt of application. The files wUl be hald for a maximum d five business days for review. Appointments <br />should be scheduled accordingly. <br />3. A fico tliat In actively bolftg worked on by EHD staff may not be Immedlataty available for review. A now applkc- on may be <br />subenitfed when the Cie Is available - <br />4. AnyfOa not r+ebiw*d In the same condition as released wilt be reorganized by EHD staff at the expense of the eApllcant. <br />Future fie rvviswa by the same applicant may require a $125 deposit prior to navlew. -"d0XP-D AAAA'm EHD USE ONLY <br />357 q-1 --0 -3/o4✓` to 140 L#'S -- 3bOt RtiFr`c . .P; L <br />Rece�ved Time .Nov, 18. 2014 1:14PM No. 7582 (•inqredtc-n IAc- 6Cj-'�',' <br />7T-C5ecr- e +' <br />