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Y- 6f TOWN & COUNTRY 2093695859 TO:4640138 P.1/1 <br /> -, bAN JOAQUIN I;OUNTY <br /> ENVMONMENTAL HEALTH DEPARTMeNT <br /> MAY 3 12013 1660 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/eh� <br /> ENVRONMENTALHEALTH <br /> PERMIff/82EP110ES PUBLIC <br /> nn RECORDS RELEASE APPLICATION <br /> APPLICANT: C_tnr�S-��M� IKc1LI BUSINESS/AGEiNCY: �0 + <br /> �e pew <br /> ADDRESS: g (J , v� CITY/STATE/'lIP: <br /> PHONE(1): PHONE(2): ACej-ZL 1- SC3S FACSIMILE: 7(�-3Lp(- SgSDI <br /> TENTATIVE'APPOINTMENT DATE: f uA-{ y— (� Time: ��0 <br /> (Plena allow 10 business days from d of i pilcallon submlttl 7err(adw only-must be conttnned) <br /> ❑CHECK 1307(TO EXPEDITE REQUEST $ FE (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List❑ Map-Desgription: <br /> FILE ADDRESS EHD USE ONLY <br /> Strati N Street Name City 4 El unit <br /> tD <br /> q 9 _ nit l <br /> r,7J4. <br /> Zf unit 3 <br /> 5. <br /> 8. <br /> 7, To view the HMMP(Hazardous --7 nit♦ 66 <br /> B Materials Management Plan) please <br /> g go to the following website: ❑Unit 6 <br /> www.sjmap.org/hazmatviewer/viewer.asp <br /> 10. , <br /> Unit 6 <br /> SpocNlc Date Range of Information rlaques0ed; From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �UNDERGROUND YANK(UST)CLEANUP SITE(LOP) ❑MEDICALWASTE FACILIrY MSOLIDWASTE FAC NEWLE <br /> OTHER CLEANUP SITE(NON-LOP) HouSWGABATEMENT ❑WASTE TIRE elf tJ /0/-10tI ?J <br /> [&UNDERGROUND TANK(MOHrroRINU/REMDVAL)-LFOOD FACILITY ❑DAIRY �G- II-i3 <br /> ABOvFGRouND TANK cx o CHICKEN RANCHI Doo KENNEL ❑WASTEWATER TREATMENT EI.ANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALR�!— ❑MOTELIHOTEL ❑PUMPER THIICIfIYARDICHEMICAL TOILETS <br /> TIERED PefuuTfED FACILITY PooLIBPA ®LAND USE APPLICATION SITES <br /> ❑TATTooIBODY PIERCING COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMR RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(ExCLUDINGI HOLIDAYS) <br /> i. List up to ten eddreaM 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 Its selected, Fax to(2091464-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the eppilcant If any END fibs 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 Ills that Is actively being worked on by END 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 END staff at the expanse of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ^'BOXED AREA-EHD USE ONLY <br /> 10-17 i u <br /> O Records provided by Staff-PPR Complete.scan Name; <br /> ENP�e-0e - 9una <br /> Received Time May. 31. 2013 2:47PM No. 3246 <br />