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eeDATE RECEIVED <br /> RON 10■ SAN JOAQUIN COUNTY EHD LOG.NUMBER <br /> �Q�#—& G Q _�� ENVIRONMENTAL HEALTH DEPARTMENT <br /> i m " 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> FEB 13 2013 Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd & <br /> ZN p;V vue_, .;._ <br /> -;, T� PUBLIC RECORDS RELEASE APPLICATION <br /> nD L&r BUSINESS/AGENCY: P- <br /> aDDREss: 2�7I �yLfYOt`�£ PTV PI <br /> CITY/STATE/ZIP: <br /> C,toJeS , <br /> PHONE (1): .SSQ, r,,7• F22_5 PHONE{2): _y FACSIMILE: <br /> TENTATIVE`APPOINTMENT DATE: - Scfq6 11 L <br /> (Please allow 10 business days from date 1 applica onsubmittal••Tentative onl Time: I 1 �bfl_ <br /> y-must ha conRrtnad) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$1 FE (CAS CK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN <br /> DATE <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Streat# I Street Name <br /> � City <br /> 1. -- ❑Unit 1 <br /> �„ 71 <br /> 2. <br /> 3. L Unit 2 <br /> 4. <br /> 5. - _, unit 3 <br /> 6. I �� <br /> 7. _. _. _ --_yO,.J,Unit4 <br /> 8 To view the HMMP(Hazardous <br /> 9. Materials Management Plan)go to the n unit s <br /> O following website:www.sjoesdata.org <br /> 1D. <br /> Specific Date Range of information Requested: From -1�'Gnit 8 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES to <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACM'YNENI _ <br /> OTHER CLEANUP SITE(NON-LOP) ❑HWSING ABATEMENT WASTE TIRE 2 EH CI.1J� <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑Foob NG AStY ❑DAIRY _3h 1�-' /y✓ " I rJ <br /> BOVEGROUND TANK p` ❑CHICKENRANCH?DOG KENNEL El � <br /> AZARODUS WASTEIHAZARDOUS MATERIALS KIWASTEWATER TREATMENTLA-141-13 <br /> ❑MOTELIHOTEL ❑PUMPER TRUCKIYARbICHEMK:ALTQILETS <br /> TIERED PERMRTEp FACILITY Ux. PDOUSPA <br /> ❑LAND USE APPLICATION SITES <br /> ❑TATTOOBODY PIERCING <br /> COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AYAILA9LE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:DOPM(EXCLUDING HOLIDAY$) <br /> 1. Lfat uo to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate- <br /> box(es). ,t least one file type MUST be selected. Fax to i209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted•for additional assistance with file addresses, contact the END. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant If any END 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 /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews b the same applicant may require a$125 deposit prior to review. <br /> _ •+dQxED-AREA=E:HR USE ONLY <br /> q .,711 0 i lecJU c� 1°c <br /> Ll Records provided by Staff-PPR Complete.staff Name: <br /> EHD 4U6 <br /> Received Time Feb. 13, 2013 1 : 154 No. 2313 e""' <br />