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DATE RECEIVED � EHD LOG NUMBER SAN .I6AGIl'N COUNTY, ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 V ` Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd PUBLIC RECORDS RELEASE APPLICATION APPLICANT: Tina Cheney / Geno Olson BUSINESSIAGENCY: Neil O. Anderson & Associates ADDRESS: 902 Industrial Wav CITY/STATE/ZIP: PHONE (1): 209-747-0640 -Tina PHONE (2):209-367-628-1898 - Geno FACSIMILE: 209-333-8303 TENTATIVE* APPOINTMENT DATE: Time: (Please allow 10 business days from date of application submittal -*Tentative only -must be confirmed) X CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT Tina Cheney- digital signature -okto expedite DATE November 30,2012 Electronic Information: ❑ List ❑ Map -Description: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES ln. I X UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY X SOLID WASTE FACILIT NEHIC ''^ �ktn&? X OTHER CLEANUP SITE(NON-LOP) X UNDERGROUND TANK (MONITORINGIREMOVAL) El HOUSING ABATEMENT ❑ FOOD FACILITY FILE ADDRESS EHD USE ONLY ❑ CHICKEN RANCH/ DOG KENNEL, ❑ WASTEWATER TREATMENT PLANT Street # Street Name City ❑ Unit 1 1. 1443 Navy Drive I� �CTey1� Stockton, p ) ❑ OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) 1505 Navy Drive2e ` Stockton ( �j Unit 2 W1 5� 4. 1023 Pershing Ave Stockton p06LA0,No p Gnit 3 OL. 6. 1041 1415 mauwdnoAva� Anderson St. Stnekton 114 Stockton /�/u y�� + l• jU I 1 1 /�fLf" �rr' 11Unit4 7. To view the HMMP (Hazardous 8. `r' > k Materials Management Plan) go to the ❑ Unit 9, following website: www.sjoesdata.org f 10. Unit e Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES ln. I X UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY X SOLID WASTE FACILIT NEHIC ''^ �ktn&? X OTHER CLEANUP SITE(NON-LOP) X UNDERGROUND TANK (MONITORINGIREMOVAL) El HOUSING ABATEMENT ❑ FOOD FACILITY ❑WASTETIRE )DAJP5 ❑ DAIRY 01A IZ Lt-IZ X ABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL, ❑ WASTEWATER TREATMENT PLANT X HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTELIHOTEL ❑ PUMPER TRUCKNARDICHEMICAL TOILETS X TIERED PERMITTED FACILITY - ❑ POOLISPA ❑ LAND USE APPLICATION SITES ❑ TATTOOIBODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) rare IT P. ISI 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. Address ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. 4. A file that is actively being worked on by EHD staff may riot a im a}el av Il I for r vi A news plic tion ay be submitted when the file is available. i2 4-lZ SPQ hrfI i✓ f r+ 5 1 �- 66/ �5p �Ob bi 0, - > job I�ob � INN3. roes Prov, � ��; �-� tl� Any file not returned in the same condition reQease�w",�be reorg�W EHD staff at t e o f t e appllcan . Future file reviews by the same applicant may require a�5 deposit prior to review. BOXED_AREA_'EH o,USE O FNn ea-nF r , '' • , / : .f`' nuc!+n% ln. I �-.,FNn ea-nF r , '' • , / : .f`' nuc!+n%