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ju��k;IN E. <br /> 14159529421 _;12094640433 2 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> MAY 0 1 201? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> dI&AAMINMENTAL FIT-10H Telephone:(209)46&3420 Fax.,(209)464-0138 Web:www.sjgov.org/ehd <br /> _I-"MIT/8E1'"10E8 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: &PIBUSINESS/AGENCY: in <br /> ADDRESS: CITYISTATERIP. -Sall tca to 4 /f j <br /> PHONE(1): PHONE(2). FAX OR E-MAIL: f <br /> Please allow 40 business days from date of application subrrlittaI for the records to be availa <br /> Staff will contact you to arrange an appointment date and time to review the requested records, <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED fN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT� ��� _ DATE S f� 7_0 <br /> 17 <br /> 7. Is u to n addresses in we space`below. Select the e� of flies from tf a list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2 -0i3S 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 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 hold 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 some applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM•SM. PM(EXCLUDING HOLIDAYS) <br /> Electronic Infor€nation: ❑List❑Map—Description: <br /> Specific Date lunge of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEP) 4T FILE ADDRESS EHD USE ONLY <br /> FILES <br /> ZJNprRGRouNo TAmK(USTI Stnwt# Stnwt Nam® -city <br /> D EmuP SFFE(LOPI /��,,q L, h f? GG81laAkR <br /> os"R CL£ANU'SITE(NDkrtOP) > WK/3 r j Trot L 1 1 f°4 t`/ f ;� <br /> 4-HAZARUOUS WASTE 1 <br /> /�j f ,( { /�,, DARY <br /> �71€REO PErMFrtCO FACu.ITY 7 �V b r{LLC <br /> ZI-ABOYEaRouN0 TANK •1,• <br /> BUST(MoNrromws I ArMo4A1) ❑pt�5 <br /> 2fHAZAKXM MATEPAALS <br /> OSNLLIRFIEABE RFSPLN se <br /> K&I10 WASTE FACUTY I VEHICLE , ATEF.dtu?Itt <br /> 9I/j'Y FACILITY <br /> C".POOL I SPA <br /> SITE�fTlCJATi(yN <br /> �ANE)USE AP'PLK.ATIOH SWES •� �� �, ?.4�� --f <br /> F! SCPTJC PLIMPEP TRU,K I <br /> 18 <br /> I-,/YARD/CHEMICAL TUL£TS <br /> p WASTEWATER TREATMENT PLANT . <br /> Ho*ssiGABATEMENT .LfPA <br /> ZfJ <br /> I ..+OTELIHML <br /> r[�LIiFCKEN RANCH I DOG KENNEL UPA-LIST <br /> MPCIICAL WasTE FACRITY <br /> i <br /> OjTA,zY PIERUN(# I <br /> gbvAS-E TIRE Savo wAS,E <br /> 9 � <br /> Z"PLAW <br /> C?f 7-Ek(PLEASE SFECIFY): I <br /> i0 []Rccouv-rr� I <br /> —89XP ASA-EHDU§ tLL_y_ I <br /> I <br /> i <br /> t <br /> I <br /> I <br /> 11 Records provided by Staff-PPR Complete. SU"N..: <br /> Etta seas <br /> Received Tirne May. 1. 7017 9 : 58AM No. 1356 4 <br /> 1 <br />