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1p 27 16 04:38p Phase1Assessments 916-988-6639 p.1 <br /> `�. RECEIVED <br /> DATE FSEEPvIiA 2016EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMEN SAL HEALTH 1868 East Hazelton Avenue,Stockton,CA 95205-6232 <br /> PERM USSERVICES Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.orglehd Bqb 7 <br /> I <br /> PUBLICRECORDS RELEASE APPLICATION <br /> APPLICANT: �-� L L BUSINESSIAGENCY: ASK, 2 <br /> ADDRESS: F/4-LL.S 65�I CITY(STATE(ZIP: l <br /> PHONE(1): Aease <br /> z3�- PHONE(2): FAX OR E-MAILFi9/GSf�� LI A- <br /> w 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 review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST-"39 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 7� <br /> 1. List up to ten addresses in th pace below. Select a of files from the list below by checking 8th appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209) -0138 or mail to the address indicated above. Address <br /> ranges 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. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff atthe expense of the applicant. <br /> Future 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:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: 0 List❑Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLY <br /> FILES <br /> UNDERGROUND TANK(UST) Sipet# Street Name city <br /> El Y�CLEANUP SITE(LOP) f/7 tp r /A� nv''{Vq� /J // �.�Y^' CO G/S/U/MJ�ER �J1 <br /> OTHER CLEANUP SITE(NON-LOP) 1 u y� '"�� /^ •!'r w 1 '"�!�J / 1 , <br /> ®HAZARDOUS WASTE jjj111 e///��� �I .n V+ <br /> I`�L TIERED PERMfTTFD FACILITY 2 D` �`/\��`�J 1 � �IC� /L/I Yt_ r I'lltYi�/� (��All/' // Jy J <br /> f�LABOVEGROUND TANK <br /> •7 /ALV J�ICJ /Y �T///✓✓✓ [[[��i 1 Y j�� 1- 'p`` 1.44.{VVV <br /> PNlS <br /> UST(MONITORING/REMOVAL) <br /> ®HAZARDOUS MATERIALS <br /> SPP_L/RELEASE RESPONSE RrWATERQUALTY <br /> SOLID WASTE FACILrTy f VEHICLE 4 <br /> FOOD FACILITY <br /> I!rSiTE MITIGATION <br /> POOL/SPA <br /> DAIRY 'r �rl'ut/r U'//� ' /�� <br /> LAND USE APPLICATION SITES <br /> []HOUSING <br /> SEPTIC PUMPER TRUCK/ <br /> 6 <br /> YARD I CH ENICAL TOI_Ers <br /> WASTEWATER TREATMENT PLANT CUPA <br /> HOUSING ABATEMENT 7 <br /> MOTELIHDTEL <br /> CHICKEN RANCH/DOG KENNEL CUPA-UST <br /> m ED,cAL.WASTE FACILITY B <br /> TATTOO/BODY PIERCING SOLID WASTE <br /> IJ WASTE TIRE <br /> 9 <br /> []COMPLAINT <br /> OTHER(PLEASE S�ECFY� A==MNG <br /> TO <br /> ^'BOXED AREA-EH❑USE ONLY"' <br /> 777-U-1 - non❑Records provided by Staff-PPR Complete. staff Norm: <br /> EHD 48-08 <br /> Received Time Sep, 21, 2016 4: 36PM No. 0065 <br />