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05/09/2013 THU 11: 59 FAX 2094682999 SJC Public Works VJUUl/UUZ <br /> E.RECEIEHD LOG NUMBER VED` <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL, HEALTH DEPARTMENT J <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> s�'St-t 7616phone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESS/AGENCY:San Joaquin County Public Works <br /> ADDRESS: 1810E.Ha—knAvenue CITY/STATE/ZIP:Stockton,CA 95205 <br /> PHONE(1): 209-468-8494 PHONE(2): FACSIMILE:209-468-2999 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST 125 F S OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Ma Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City [I,Unit 1 <br /> lI 1. 22269 MARIPOSA ROAD dk ESCALON \3 "VAN•)W t 17 LQ <br /> D1/� 2. 22921 MARIPOSA ROAD I ALON IJ:, Aj waze p unit 2 <br /> ` 1 f 3. 24197 MARIPOSA ROADCl1�LON j <br /> 4. 24628 MARIPOSA ROAD ESCALON 146A rib ❑l Unit 3 /. <br /> 5. 24746 MARIPOSA ROAD ESCALON tjo�)o / <br /> 6. 14159 ESCALON-BELLOTA ROAD ESCALON ,p unit4 <br /> 7. 25368 MARIPOSA ROAD ESCALON <br /> 8. 23723 MARIPOSA ROAD ESCALON Unit 5 <br /> 9. 24059 MARIPOSA ROAD ESCALON N q5J✓ <br /> 10. 21988 MARIPOSA ROAD ESCALON 12/Unit6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT ❑SOLID WASTE FACILITYN HICL <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑■ FOOD FACILITY ❑WASTE TIRE We hit t IV i t <br /> 0 UNDERGROUND TANK(MONITORINGIREMOVAL)v�' ❑DOG KENNEL ❑� DAIRY wwz ss ?, <br /> F07 HAZARDOUS WASTEGENERATORs�_ XCHICKEN RANCH 0 WASTEWATER TREATMENTPLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL 0 PUMPER TRUCKNARDICHEMICALTOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT 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 expense of the applicant. <br /> Future file reviews by the same applicant may require a$.125 deposit prior to review. <br /> J U c �s d <br /> ti-Z r } c.1 A." j 5 <br /> ea' ' 1 r Zvi I <br /> Re ceived^'Time May. 9. 201 11 : 51 AM No. 3053 8`1 1 <br />