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RECEIVED 0 <br /> DA7E241`1 2,Ip SAN JOAQUIN COUNTY EHD LOO NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1I1flRONh ENTAL,MALTH 1868 East Hazelton Avenue,Stockton, CA 95205-6232 <br /> PEftdl T/a ; Telephone:(209)468-3420 Fax:(209)464-0138 Web:WWW.sjgev.arglehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 46rd kKk SUSINESSIAGENCY. FVG t� /1G <br /> ADDRESS: 20/0 CroeJ c +YoA P150 CITYISTATEIZIP.S �a.non e.4 5'y 3 <br /> PHONE(1): 72 570 g(� PHONE(2): q2 _5 q . :L5 FAX OR E-MAIL: °Peck �17��° r✓1 <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 /> QHIyCICBOX'TC16X>?EDfT FtE ? 7 519 F f GH�CK QNL^()-.iCIUES i'R©EEDtlp13 BUa�1NE5S-17yS <br /> SIGNATURE OF APPLICANT DATE 1'-/1^ 017 <br /> 1. List up to to addresses in s ac a ow. Select the We(s)of files from the list below 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.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 notifythe 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 /> 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$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0013M(EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List❑Map-Description: <br /> Specific Date Range of Information Requested: From to <br /> EN?VIRONMENTAL <br /> HEALTH DEPAJRTMENT FILE ADDRESS EHD USE ONLY <br /> ,-y FILE,S <br /> Irl UNDERGROUND TANK(UST) street# Street Name_ City 4 <br /> PT CLEANUP SRE(LCP) - 1 12- <br /> �-y yn n7 I�,1' /' {►V�f'L�li0 CONSUMER V <br /> OTHER CLEANUP S TE(NON-L y II�",JJ �I,�[,�y (ryrl�az,,,_ D i �ac ♦ Y <br /> HA7_ARDGus WASTE �1 ,Z Z fV'—V;7 <br /> "❑''i TIL.RED PERMITTED FACIE i u DAIRY <br /> ASOVEGRCU. TANK ' <br /> UST(MONITORING/REMOVAL) <br /> HAZARDOUS MATERIALS + [J ! a(c y. <br /> ' Dq SPILVR£EASE RESPONSE <br /> SOLID WASTE FACILITYI VEHICLE 4 I 111 WATER QUALITY <br /> FDOD FAclLlrr <br /> POOL l SPA <br /> c� _ SITE I,/imG33T7aN <br /> lyl DAIRY 6 <br /> LAND USE APPLICATION SrrEs <br /> "SEPTIC PUMPER 7RUCKI ©HOUSING <br /> YARD I CHEMICAL TOLETs s <br /> ®WASTEWATER TREATMENT PLANT <br /> HOUSING ABATEMENT r <br /> CUPA <br /> MOTELIHQTEL <br /> CHICKEN FLINCH I DOG KENNEi, /CUPA-UST <br /> MEDICAL WASTE FACILITY B <br /> ©TATTOOBOOY PIERCING <br /> E3 WASTE TIRE t ti SOLID WASTE <br /> COMPLAINT ° L /} <br /> OTF{ER(PLEASE SPECIFY): ~� "-711 -7. <br /> 90 Q ACCOUNTING <br /> I <br /> ""BORED AREA-EHD USE ONLY— <br /> :r <br /> 1, <br /> ❑Records provided by Staff-PPR Complete.staBName: ` <br /> EHD 48-06 <br />