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ISE Pege11 ofjf�`' � r 1 2016-08-08 05:23:33(GMT) ����884443080 From Pawel Woloszyn <br /> im DATE RECEIVED EkfU;LQG.NJMBER <br /> f09 SAN 4OAQUIN.COUNTY <br /> le <br /> AUG a 20�6 ENVtRQNMENTAL I^IEkLrH DEPARTM'7'61 <br /> • 20 <br /> EMjR0NM1E=t�ALw i8(209)4 Hazelton Avan09)ue, 46-013cldton'CA 6w.ww.sjg <br /> F"F�''c GTd�ERiG10E5 _ 'Telephone:{209)A68-3420 Fax:(z0E)464-013$4Veb:vnvw.sjgov.orgJand <br /> PUBLIC RECORDS RELEASE APPLICATION PacificEnvironmental <br /> APPLICANT: _ Pawe{Wolomn gU51NES81AGENCY__ anagemen , nc, <br /> ADDRESS: 1500 W:Et Camino Avenue#220 CITY/STATEIZIP: Sacramento,.CA 95833_ <br /> PHONE:(7):, .91.6-444-1654 PHONE(2); T.. FAX'Q.R E.,MAiL: pem_inc@yahoo:com <br /> Please allow#0 business days from date.of application.submittaI for the records to be available.. <br /> Skaff.wllt aonkact'.yQs.ko.atrange an.appointment date and time to review the requested records. <br /> ®" ECi ��1x' a ,p ft a i sr 5 as e sM i cHi x t rsLYp'' ra Ear p � F s c a PPS;s.ss OW <br /> SIGNATURE OF APPLICANT ;«-.�?�f h — __ DATE 81$/16 <br /> 1. List upto ten addresses in.the space below. Selectthe.tYPe(s):Offiles from the:Eist below by rhecking the appropriate <br /> box(es). At ieastIone-fille type MUST be selected. Faxto(209)464.0138 or mail to the address indicated above. Address <br /> ranges will—not be accented.Applications received after 3:00 pm Witt 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.(1:0) <br /> days after receipt of application. The files will be held for a maximumoffive businessdaysfor review, Appointments <br /> should be scheduled accordingly.. <br /> 4. Any file not returned to the same condition as released will 6e reorganized by:EHD staff at the:expense of the applicant. <br /> Future lite reviewsby the same applicant may require"139r deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW`. MONDAY-FRIDAY 8:00 AM-5:ODPM(EXCLUDING HOLIDAYS) <br /> Electronic Information' ❑ List ❑ Map—Description. <br /> Specific Date Range o-rInformation Requested: From 4Ii Available to <br /> EBdtIlRt3k&1�fatT'A�, <br /> t{EAkTHDEPAR.WE-NT FILEADD ESS EHD USE ONLY <br /> - <br /> INUNOERGROUWGTAxK(UST) Street ' Strut Name, City <br /> C;LEFNu SITE(LRP) C/^prsoxz'�. <br /> 4TNER cvxmuPsnE ium,a,oPl.. 260€. Teepee Datis e Stockton /ro <br /> HR3aF,aoue 4N,1SrE .. p Oainr 8l P <br /> rttPp Q <br /> ©TlEvmEu taUW + 0455 TeepeeDn.ue Stockton f <br /> ©AbOY�^ROVNq ThNA �A'� nP1M5 <br /> MUST (M(00TORINGi P,a3dOVk;.1. <br /> �.HansDcus�tATEP1us G -2365 T opeeDziuc Siocktc+n, 1A�Q�[`/ <br /> IR 'HSE r;tesp E wATER.CUFiT' <br /> M solo WAST Fa.a:iry 2735 N.Tv,,peC:DrivC <br /> Q Fond FAccnv <br /> Jrr_Ad/?uM1H;1N <br /> �POs_!SPA <br /> n©� <br /> ©LpnU IGEWsur✓.i1GN.$tIEE. �H:oL6aiG <br /> SEPI-PUMPER TRUCK/ <br /> 6 <br /> '❑wA..TEW6TER:TR '44e pLUwT WFF <br /> ❑,HOVSING ABA'J.1ENi' 7- <br /> ❑'MOieiIHOTtt <br /> r+` CU2A+OS7 <br /> .�.vniGKEN Rh'NGR i.n.7.'>xENNG' <br /> tAEO4Cn!WA TE FRa -- '8. <br /> ❑TA'TGORipGYPL-RCENG �$py.wnslF. <br /> ©' Y1ASiE T!R.E' <br /> M C7fdPW`.T <br /> OTHER(PEEASE$FEOIr"Yk - E3 A—n-- <br /> Write UdI&Septic System to <br /> �^ —90xEDAREA-EV'.n USE ONLY— <br /> 1 f' <br /> ❑Records provided by Staff-PPR Complete. Stott Name. <br /> EHD 4"6 <br /> Received Time Aug. 7. 2016 10: 22PM No. 1072 <br />