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09/13/2017 2:29PM FAX 2099440163 WERNER PROPERTIES 20001/0001 <br /> DATE EIVEW� SAN.IOAQUIN COUNTY @Hn LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SEP 14 2017 Q�`� 1868 East Hazelton Avenue. Stockton,CA 95205-6232 Q <br /> Telephone:(209)4683420 Fax: (209)464-0138 Web:www.sjgov.org/ehd4? 7 <br /> ENV?ROWICNTALH PUBLIC RECORDS RELEASE APPLICATION I IS <br /> v` <br /> APPLICA BUSINESS/AGENCY: �V ✓� <br /> ADDRESS: CITYISTATE2IP: <br /> PHONE(1): Z PHONE(2): FAX OR E-MAIL: dL <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 appoi tmerd date and time to review the requested records. 7���/ <br /> ❑ CHECK BOX TO EXPEDI EST-$139 FE OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU INES DAYS 5y": <br /> SIGNATURE OF APPLICANT DATE /7 <br /> 1. List up to ten addresses In th pa bel . S le t pe(s of files from the list below by checking he a propriate <br /> box(es). At]east one file type MU T be select6d. Fax to(209)404-0138 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 recelpt 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:OOPM(EXCLUDING HOLIDAYS) 1� a <br /> Electronic Information: ❑ List❑Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTHF LES ' " NT FILE ADDRESS EHD USE ONLY <br /> UNOERGROIIND TANK(UST) Straat# Street Name City <br /> CLEANUPp� G <br /> SM(LOP) ----"--" 1\/1 fansuuen <br /> OrNER aEANUP sere(KON-LOP) � �,� <br /> vuWASTE q DA <br /> .TIERED PERMTTIEJI FAGIIITY E _ <br /> F1ABOV Oum TANK ' .L <br /> UST(MONITORING I REMOVAL) (����� u�� [3 PWS <br /> HATMDOUB MATERIALS S - --�_ ) !!!!(1111 <br /> fOO <br /> ILURELEASE RESPONSEh� ..y�.••��� }lUDWABMFACI IVEHICLE / V� (,/ - ^/tQS� tQ,�y „_'I'W^y FACIU7Y <br /> ❑POOL I SPA ( []SITE MIn4ADON <br /> rl qS� <br /> DAIRY 6 W(/1M1/I �N`t,i//LC19 <br /> LANA 116E APPLICATION STIP-8 N_ <br /> $&Ift PDMFER TNUDK I Q HDUNx <br /> a <br /> YARD/CMFIAICW.TOILETS <br /> r_JWAET ATERTREATMEM'PUvn <br /> ❑ (BATEMENT T fUf �CUPA <br /> HOUSING A <br /> ) fThe f^71L o1-l:�vyU �'}iL' �I�n11L..7 <br /> L]MQTWHOTEL Asr <br /> ❑CHICKEN RANCH/DOG KENNEL I �T 4'-T E, p cuaA•uaT <br /> MEOIOAL WASTE FACILITY 9 I <br /> ❑TATTOO/BODY PIERCING <br /> ❑WASTE TIRE /; - ❑Soup WASE <br /> 9 <br /> COMPLAINT <br /> ❑OTHER(PI ESP FY)! .�'- .... <br /> ACCOUNNNG <br /> 10 <br /> b —13OXED AREA•EHD USE"LW- <br /> El Records provided by Staff-PPR Complete.srairm n : <br /> Received Tlme—Sep. 13. -2017 3: 20PM—No. 2289 <br /> b <br />