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DATES EHD LOG NUMBER <br /> y <br /> H1 riN�pIAS � SAN JOAQUIN COUNTY 0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 60 3"3Q 1868'East HazeRon Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> 0-346BLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: EDWARD MACDANIEL BUSINESSIAGENCY: NOVA CONSULTING <br /> ADDRESS- . 3210 GOUGH ST 4105 CITYISTATERIP. SAN FRANCISCO, CA 941.23 <br /> PHONE(1): 415-240-3205 <br /> PHONE(2): FACSIMILE: 415-070-2038 <br /> TENTATIVE'APP01NTMENT DATE: Time: <br /> (Please allow 10 business da date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE R E5T 125 FEE(CASK OR CHECK Y) REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE- 12/9/2013 <br /> Electronic Infortnation: ❑List❑Map—Descrlptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> ��.. Street 0 Street Name City 0 Unit 1 <br /> '1. 1176 ROSEMARIE LANE TOCKTONTWI <br /> cv�j .$. 1100-129 MONACO COURT STOCKTONp U.lI"' ��Unit2 <br /> 3, 4131 N. CROWN AVE STOCKTON ,lUJ �'J <br /> �4. 4444 N. PERSHING AVE STOCKTON 'L( c0 Glp" . - Unit3' ' <br /> 6., 4501 N. PERSHING AVE STOCKTON <br /> -B 4445 N. PERSHING AVE STOCKTON t lJ<nit4 ry <br /> 7. 4555 N. PERSHING AVE STO KTON MIM <br /> r � ' <br /> 8. ii-3a AA ana.60 A .Inrl IkA�� <br /> I _ Rit <br /> 9. <br /> 10. <br /> Speciflc Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES i <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP)) ❑MEDicAL WASTE FACiLmr [2gSWDWAsTEFAClUTY1yE II <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT (DWASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOYAL);�, ❑FOOD FACILITY ❑DAIRY1�(-Z <br /> ®ABOVEGROUND TANK o f ❑CHICKEN RANG(!DOG KENNEL ®WASTEWATER TREATMENT <br /> ®HAZARDOUS WASTEMAZAIMS MATERIALS C7- ❑MOTELIHO:ML. ❑PAMPER TRUCKIYARDICHEmic&TOILETS <br /> ®TIERED PERMITTED FA0Lr t.,e . ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑.TA7T001ElO0Y PIERCING ®COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM 5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0131 it to the address tate . Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHO tiles 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 /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> subrfiltted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be morga nixed by EHD staff at the ex ense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ' <br /> ;:•^- <..`�--, ,u,vyv�.�,;•..{: <br /> ,yam ., <br /> cr_te t.,'.'�- t _ .s. 4. :• J -OM1 A ..,y4'4 "' ;a'�t <br /> ..is <br /> :.5; :-:; .�.` "f. '.s})', - ,:s..,: ;,,�v`'•4ci^.w;ti:.- -�— .:a I�r. .;,�," - �-•`x.75 -_�1,_. <br /> r , - F1' <br /> v — 'zc ., <br /> �.-�k;yy• .. ..4,�,�:.:,?.}Y:k St ' <br /> fF.1 <br /> .:4} � •y '' !" ?�'b 1:,4�'AL_ J 'j r <br /> e"0 `I klYl� h�< u5 TJ,46rtpol <br /> us�l M 1A57�, 74 yUyG E h� � ��Ovi'� <br /> };4A+ a 4W ForL195,51 &5v" - C000z, of d60 02. <br /> Received Time Dec. 9, 20 DM No: 4709 --' ' <br />