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CZ— E V (imp' 1s:se:o3 os—Ia-zoi6 <br /> ERECEIVED 1 /1 <br /> aw AUG P i 20 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT EHD LOG NUMBER <br /> 05-6232 <br /> �WIRONMENTAL HE LFT-t Telephone 8(20)468-34268 East 10 Fax:(209)464-0136 Webton Avenue, Stockton,CA 52www,s gov.org/ehd <br /> FEf�f�l T€SE�i RGES <br /> PUBLIC E�ECsOF2CS RELEASE APPLICATION <br /> APPLICANT: I �< <br /> 2Ca vYt ail c f1 .. . gUSENESSIAGEHCY ADDRESS3 (?-P4, <br /> PHONE <br /> qDl� '2. CITY/STATEtZIP: i., VLrj , 4 <br /> D PHONE(2):ej�c�_ z� ,zJFFeXORE- <br /> Pteaseallow 10 business days from date of appflcafian submittal for the records to be Oval{able. <br /> MAfL: �rLS'�'I <br /> SEaff trill contact you to arrange an appointment date and time to review the requested records, <br /> ❑CHECK BOXTO EXPEDITE%E VEST- t ��1 <br /> SIGNATURE OF APPLICANT A 5139 FEE CASH OR CHECK ONLY - <br /> �- .. �� ) REQUEST PROCESSED IN 3 BVte' <br /> SS Ay5 <br /> f. List uo 4o ten addresses in the s ace below Select Ehe DATE(es), At least one file h'P s)of files from the list below by checkin ranges wlll not be accepted.Appllatlonsreceived after 3:00 pm will beessed fhe nett business day, <br /> pe MUST ba selected. Fez fo 209 464-0136 ormali to the address IndfeafedabP ro�ddress <br /> notify the 3- The For assistance will <br /> ee In identifying the nature and content of EHD recordses axis ,please canfacf Elio of the number noted above. <br /> if any EHD <br /> 3. days after reeetpt of appation applicant The fl es will be held faAn mpoi appointment <br /> for flue business be c fofi�review, Appointments <br /> should be scheduled accordingly. , ten(10) <br /> 4• Any fife not returned in the same condition as released will be reorganized b EHD s heapp ican <br /> Future fife reviews by the same applicant may require a$139 deposit prior to review, <br /> y faff of the expense of the applicant. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 9:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> EEectronic fnforrnation: ❑ List❑map-Description: <br /> Specific Date Range of Information Requested. From <br /> ENbRROR4MENTAL I�a��_ to ( <br /> HEALTH DEPARTMENT <br /> FILES FILE ADDRESS <br /> � UNDERGROUND TANK(UST) Street f <br /> EHD USE ONLYCLEANUP SITE(LOP) Street Name City <br /> CRIER CLEANUP Slr(ND -LDP) f✓ <br /> HAWOUS wASTE PvFo}1+ 0DUY-' f `Oyt$C <br /> _ <br /> . 1 1 ❑COHSUMEfl 1tVj <br /> y��� �� <br /> 1 <br /> TERED <br /> �AVEGROUMRTA FACILf1Y 2 C /'� �r t K..� <br /> 90VEGROUND TANK l/T7`^moi �� o � ❑Davyy ' <br /> -Q LIST (MONDDRNC I paNOYAL) <br /> f&AZARDous MATERINS a <br /> SPE/REEASE RESPONSE �� 1L � . <br /> I3 PWs <br /> SqSOUDWA FA111VEHICLE <br /> fJ FOOD FACILtiY ,/� S 1— 0 l�(✓ +�J I Yt' ' lvt7 t 1 S L W <br /> ^ � War=n puunY <br /> M POOL/ 11Iry E n'► C.� <br /> ONRY 5 <br /> LAND USE APPLIGTION SDRE MM.ATWNEs � <br /> SEPTIC PUMPER TRUCK/ <br /> YAP.o/DHEMIL0.L TDIIEfs e <br /> yn� t❑,Housxo <br /> WASrMATEH TREATMENT PLANT <br /> n HOUSNGAEATEMENT <br /> 7 <br /> ❑MOm/1{oIEL COPA <br /> (]CHICKEN RANCH/DOG NENNg <br /> El MEDICAL WASTE FACUI B <br /> EI TAITDD/appY PtERLMG LUPA-UST <br /> F-1 WAsie TINE <br /> F1 co&u, wT 9 S0wv WAST, <br /> El OTHERWUEME SPECIFY): <br /> 10 <br /> ❑A=o NnNO <br /> ^aOXED AREA.END USE ONLY— <br /> IR <br /> NLY^ <br /> [7 Records provided by SEaff-FPR Complete. sten Name. <br /> EHo Ossa <br /> Received Time Aug. 10. 2016 4i00PM No. 1085 <br />