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r: L2-0jV Lty No 0410 P 1/1 <br /> DATE RECEIVED !'j„�(� EHD LOG NUMBER <br /> �� � �"�`' SAN JOAQUIN COUNTY <br /> 11 �"Z ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1866 East Hazolton Avenue, Stockton, CA 952015-6232 <br /> VNVMN ErhVrAL1 `.� L�1! Telephone: (209)468-3420 Fax: (209)464-0139 Web:www.sjgov.org/ehd <br /> PEIM1TFSERMES PUBLIC RECORDS RELEASE APPLICATION! <br /> APPLICANT: vCLA BUSINESSIAGI;NCY: � j�fll/)JOrTmeN <br /> ADDRESS; �c� � � �rec � tin r. � r' � I CITY/STATEIZIP: yl�wc�,r (' �'I'�`�-t`r. <br /> PHONE(1): ,$I4-, I'l'7-q�BS� 430 PHONE (2): " 3'�� ,?, FAX OR E-MAIL: 4' . rQ W 4—) 64 7= <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 appointment date and time to revlew the requested records. <br /> HECK BOX TO EXPED[TI=REQUEST- F' (CASH OR CHECK ONLY)-REQUEST PROCESSE=D IN 2 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ,?—I"I17 <br /> 1. List up to ten addresses in the sp ce below, Soloct the type(s) of tiles from the list below by chocking the appropriate <br /> box(es). At least one file type MUST bo selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> rangos 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 receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. V <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 /> Puture 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-5:001"'M(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: Frons 117to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES fl L.�y �� USE G I�C ���I <br /> UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEANUP SST&(LOP) ,�f� //\\�� (\�� Ar JI COcS3SIh1ER <br /> OTHER CLEANUP SITE{NON-LgP} f'H JG V ,]rl.(I`[J,�JYI{-_- VP/ / Y' <br /> HAZARDOUS WASTE <br /> YYY!';""TIERED PERMETTED FACILITY <br /> ISrr Aeov9QRou140 TAINX f CCCiiiIVVV w y V U ltll 1V I� Lf`y'y�� /� <br /> 1l`8'4'UST (MOMRING l REMOVAL) ] ( 4 / PWS <br /> AZARODUS MaTERia1_B \J A �rC/ <br /> SPILURELEASE RESPONSE <br /> ATER 6OALITr <br /> OLID WASTE FACILITY!VEHICLE <br /> �raoi>FAelurr <br /> POOL/SAAU rl1 ITE MIY>WTION <br /> p Dwiy 5 4� �aJ Y�. <br /> LAND USE APPLICATION SITE& <br /> SEPTIC PUMPER TRUCK IB '3 1.+�`-*�"` ❑H[IUBINO <br /> /Ls/7 <br /> YARD)CHEMICAL TGILETS '' <br /> WASTEWATER TREATMENT PLANT „!1 j <br /> 1 ' C'r � UPA <br /> '❑HOUBINr ABATEIAENT 7 I�f 1 <br /> MOTELIHOTEL 1 <br /> CH9C96N RANCH/DOG KENNEL lsk&FA-UST <br /> F1 MEUICALWA, FACILITY e <br /> TATTOOIBCOY PIERCINM <br /> SOLID WASTE <br /> WAST'&TIRE <br /> s <br /> tgLCOMPLUNT <br /> ❑07HER(PLEA8E SPECIFY): �1 <br /> ALIOUM'NP <br /> 10 <br /> Amok .g O P L <br /> tAl Wel Vr f QLe:v 4 Tc° ry y <br /> LJ Records provided by Staff-PPR Complete. sraffName: <br /> Received Time Aug, 1, -2017— 2 : 59PM No, 2016 <br />