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yyyttt�� 6lOd 'S 'AON a1U11 paApoa rID 0 IM '°N WV EHD LOG NUMBLH SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 one: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd F��PFPt�ITISERu1�ES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: 1 ] }IAA (1 1 Q BUSINESSIAGENCY: Pt11f�Rr ��qc K eP F'I�YfG ADDRESS: CITYISTATE/ZIP: l PHONE q) C7W-qAI PHONE•(2): FACSIMILE: TEAITATIVE'APPOINTMENTDATE: Time: (Please allow 10 business days Irom date of applicaBon aubmiBal-•Tentative only-must be conflrmetl) - ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE.OF APPLICANT DATE Electronic information: ❑ List❑Map-Description: FILE ADDRESS EHD USE ONLY Street Street Name City Unit 74 ` t p %+SMP( Fars hl y 2 nit 2 3. I I 4, unn'3 5. 6. nit4 7. 8. Unit 5 9. % ❑Unita SpeclHc Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES L42NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FAC YLI{�IrEHIC�I�E.� /,^ OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE 3 v2IC r-. j'6�'� [UNDERGROUND TANK(MONITORINGIREtdOVAL)Lj ❑FOOD FACILITY ❑DAIRY T 11-JI-13 Er¢7;A1.�BOVEGROUND TANKO` ❑CHICKEN RANCHIDOG KENNEL ['WASTEWATER TREATMENT PLANT E2PHAZARDOUS WASTEIHAZARDOUS MATERIALS-'— ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. - - -- -- - - _- - - - --- 3. A Nle that Is actively being worked on by END staff may not be Immediately available for review. A new application may be submitted when the Nle is available. by EHID the ex ense of the applicant. . 4 Futures Nle reviews by the same applicant may re1eulre a$129 de oslt nrlorlo review.�ff atp s .dt{L' Y PP Y 9 P P a : I1 ! r Irl t 1I .at xl I : r P III ! 1 t «. el 11! 5i!i{; a 111 4 : Illu 1 ca s lrI � EII': em � 1. .. .....�.} .. . . ._ � . L !!a!n?:bi .9.,:L!J.!!ilaL!+.tliilliElL.ifLl'nd!.IlLII?a.... �.. .....tliuiv uhf c* ... :_.•-_ au Ll:n: w:. ':. ;. .I L:":': •;:inaVL:rc:nbaE^.rya:v::::a:::v::::::�::a«:::rL:G:PgIdnI:•1 ::I::9t':9•:::r•Ly k::F:.I:::::• '1'L': ::: «.:.::r«:::•L:r..^..:.^.a:::aa4'O" _.P.......s..;,...... t .i I 1 : a h..�.1 1.'y3.int _.6 _fl.7.....f.._.v....._ 4hxmmiF r••• :;'r"•':i nl ax !9 u 1 - .•.'..'.'na:: :� _La..r..aud:uv:a-:a.ma.:::.;:..„.,.;Ee t ��. 11.. 3.1 .....- .. .......... ........ ..:....,.. .._. -¢a�l::wl.:::;°!:yt1:1 c:!'c:::nvcr!EEDi:rn:e¢ l.. I . eLsann:ar:::c::::9s^.asxar...rl'�.c i;:::a:ax::::.a:::.r.:::::r.....¢::::::::r.: :::•.. . .. ........x...............�,...--. ^L"9115:::':'�1.:^::.:".1.'::L':::�^�... I.�..I...i.Si't^.•.i:::^::«':::::"::'::::'::..v::-'�:-�::'^.;y^•:1•:'::«"::.:':::.::•`:�"::::::1:5::: ..Till'ELII'1 NI11:I II::L::::I:I'J.:t:_li:: :::::::._�_. ... ...i. ..:...: ..... ::. I........u,...l._L.t. la vu:..9.ugrcLfrt:9!::::f19'9::!::d!L:rc::h:9:!'v::7«:a:::air,:a!e:::21c!Irru::::x9.':«:aa�ae sora::« lr.:n:::e:Lar.:::::r..:9:::::::::•n_;..Ia! I:!::II�!dluc:.-.rr:alrl.leu I v;a'. i.,il "r..-r.:a:;{1•egl:;,!«I{IIIc:1::!i:«:;'!yrI!:e:ur:::.::el:m::c._;.........___.._....I. L P li :•^! c ^:�...... :..I .....:........2..�,§.... ._L........._..._...._:re::u9:;:::u::ual::.a9sl:n: ::a._mL91•:x,v: nrr La na'ce9:::::9ri"'"'y"' m:mac•ganrcuu:::::a 1... t. .. '..•. a �... -:}^�i;.y, ■■^• n� •'• �,�ItEl"Ir^^ ^.:rl•1•Iiiil)EnJi7ie:diii 9::r.::!iiirii«!!ienuii!!E!isiBii2iLi:nkvuiiiiyii!iaii�rr..!ln:mF....a:-u =��:iss:ii::ii` . '.i:'i..-_.._.:¢.Tf4�9�t .:� 1... Y....:dT si..,Fl7i:1L�*r ......�I:1�t�Sff.Rf'�: .. : . 11lI«t.:an�lc:r:ei'^•9:.-.a 1. ...::rer:nl•.«a:vin::r::u94::a.`..I�s.a::::?!:::: !::::ug::....:�-�:::a. EI-11348-DO 914112