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�Vo V.8 No. 3226 P,DATE RECElV17a <br /> NOV 11 2016 SAN JOAQUIN COUNTY EHD LOG MJM13ER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRO-NMENT4LHEAL7N 1868 East Hazelton Avenue, Stockton, CA 95206-6232 <br /> PERMITISERVICES Telephone:{209)468-3420 Fax: (209)464-0138 Web:www.sjg©v.org/ehd <br /> 85080 <br /> APPLICANT: <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 'S� -�� <br /> ADDRESS: BUSINESS/AGENCY- rl G V1fO <br /> PHONE(1): r — PHONE(2): CITY/STATE/zlP: <br /> Please allow 1U business days from date of application submittal for the records to be available. <br /> ...-.__.-. .._..._.- -Q _PP� t date and time to review the requested records, <br /> staff will contact you to arrange an a ointment date <br /> _. E - _ _ <br /> CHECK PX C EXPEDITE REQl1Eg $i39 F E.(C 3H OR CHECK gNl y)-REgUEST pROCE3SE D!N 3 BUSINE55_ DAY_5 <br /> SIGNATURE OF APPLICANT -- - <br /> 1• List a to ten addresses in the space belov�r, Sal® the "�' DATE I! j <br /> box(es), At feast one file type MUST be selected Fax tpe(s)of files from the list below by checkin h a <br /> ranges will not be accepted,Applications received after 3 or)g 464-13®p r male to the address Indicated aboverophnte <br /> pm will be processed the next business day. Address <br /> 2. For assistance in identifying the nature and content of END 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 a <br /> days alter receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. approximately ten (10) <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the appllcant. <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:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: Lj List Q Map_Description: <br /> Specific Date Range of Information Requested: From <br /> ENVIRONMENTAL to <br /> .SAL I bEPARTMEMT FILE ADDRESS <br /> .._. ... FILES -...-_ <br /> 0j UND2RGRouND TANK(UST) Street# EHD USE ONLY <br /> Street Nam@ City II�n� <br /> CLEANUP SITE qty -�t�Q��y/�^ �Jy,I�,� 777 ��y,/�( �rGG <br /> OTHEp CLEANUP SITE(NON-LOP) 1 1''�� L'JL"✓I 1 �'r✓I+ ` n CONSUMER <br /> Q�HAZARDOUS WASTE <br /> aTIERED PERMITTED PACIL'TY <br /> (�11''i Zip1(s�/l �GClYI � iliCLi�1Gf DAIRY <br /> �ASOvECROUNDTANK <br /> 'L IST (MONITORING/REMCVAL) <br /> 5HAZARDOus MATERIALS `" I I „ �( 6,��tl F I cul, i I 1 ❑PWS <br /> SPSLURELEASE RESPONSE <br /> [�'sOUD WASTE FAO IUTY/VEHICLE y'✓ <br /> Z'FQDD FACAITY 4 WATER QUALIYY <br /> IrPOpL/SPA <br /> aDAfRY 5 5r F,;,cAnaN <br /> P�aND USE APPLICATION SI7Es <br /> LJ SEPTIC PUMPER TRUCK! <br /> YARD/CHEMICAL TOILETS 6 NouscKa <br /> •E f WA§ EwATER TREATMENT PLANT { <br /> ZNOUSING ABATEMENT <br /> MorEUHOTEL <br /> T CUPA <br /> fY" CWCKEN RANCH/DOG KENNEL <br /> y MEDICAL.WASTE FACILITY 8 BUPA-UST <br /> TATOWBODV PIERCING <br /> +WASTE TIRE <br /> VOOMPLAINT 9 60LID WA81E <br /> ❑0THER(PLLASE SPECIFY)' - <br /> io <br /> �-ACGOiIkRlka <br /> J1 i ' BOXED AREA_ HD LISE QMLY`-" <br /> Records provided by Staff-pIII R Complete, SUffName; <br /> Received TMe—No—V- 21. 2016-10: 3CAM`No, 0179— <br /> ........... <br /> 379 � <br />