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■f From:51033a3192 09/07/2017 12:51 0575 P.001/001 <br /> ■ <br /> RECEIVED <br /> ■ ■ DATE RECEIVED OIL�jd SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ■ SEP G 7 201? 4-1 ENVIRONMENTAL HEALTH DEPARTMENT 7 <br /> 7: (2 East Hazelton Avenue, Stockton, CA b:www.sjgov.org/ehd ` ��� <br /> �/{ �( Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PEMIT/SER" E9 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: IN'4 BUSINESS/AGENCY; AEj CoL,3,1+l A+S <br /> ADDRESS: 510 3-1 CITYISTATEMP: 0+kla,d C/F/ 94-60 <br /> PHONE (1): 2µ0-1-52 - 2 0}'( PHONE(2): SIr) - q0}- 3/4-S FAX OR E-MAIL: . hpvLkai2 Ali consp Ilan{-5 -Gor <br /> Please allow 10 business days from date of application submittal for the records to be available. Fax 510-335- 311 <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 IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 12 DATE 9 /-4 // -?-- <br /> 1. List up to ten addresses in lye space below. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At least one file ty#e 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 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 /> 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 $139 deposit prior to review. l'� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ffList g Map-Description: <br /> Specific Date Range of Information Requested: From o 1 cit s L- to C w v w 'C <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS ,L <br /> FILES EHD USE ONLY <br /> ) <br /> • UNDERGROUND TANK(USTI Street# street Name _ City <br /> CLEANUP SITE(LOP) I I V I✓ 32`CONSUMER <br /> HOTHER CLEANUP SITE(NON-LOP) E� <br /> AZARDOUS WASTE 4ONBv <br /> KTIERED PERMITTED FACILITY ^ <br /> I—I�(ABOVEGROUND TANK ([[ /rbl f•� ` I EJyJ t. <br /> 1 Z`ST (MONITORING/REMOVAL) / ! Ea s-r" C,A IA I S /TL/ I T t•� E]PWS <br /> `I(IM HAWiDOUS MATERIALS <br /> �SPILL/RELEASE RESPONSE <br /> ff$OLID WASTE FACILITY/VEHICLE ( p fI / h u WFTER DJulm <br /> ♦h 4 <br /> ffFooD FACILITY 1 <br /> '"'--4444 PDa/SPA v//� ( () MrtKA'.. <br /> 4---- ONRY v 5 �l Y V W - <br /> LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK I <br /> ICeLR -P�rfs� -r{W f,'k , of 1 rPP <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> WASTEWATER TREATMENT PIANT A �yLUPA <br /> HOUSING ABATEMENT T /, O �ksv cS'^,6i(\.s r�1,1{qJ <br /> MOTEUHDTEI l/.�'� l/(/�L^, /� ILy� <br /> CHICKEN RANCH I DOG KENNEL t (o- ( C (.�L-rte F,(e,/ a l m S p +7jo CUPrA1-UST <br /> r✓�MEDICAL WASTE FACIUW 6 VVLL ��V/ <br /> L��4y TV,AA TOO/SGDY PIERCING <br /> p'I WASTE TIRE a. W J A ctj Its (sp,IIs Q 0-a 115 11 t r n i 4A) _ OLW wAs<E <br /> " ` 9 <br /> Iy,L COMPLAINT M D <br /> "❑---CCC OTHER(PLEASE SPECIFY): l'l/ ALcoUMINB <br /> W <br /> All— <br /> ^'BOXED AREA-EHD USEI`ONLY"' <br /> L1- 1 ( -'.+� 1CLZ Jt- �•• V M �a a hn:i M f'N <br /> ❑ Records provided by Staff-PPR Complete. StAff Nam.: <br /> EHD 4"6 <br /> Received Time Sep. 1. 2017 12 :44PM No- 2245 <br />