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F/ 9 0 2012 11 : 911111 HP LASERJET 17AX F. 2 <br /> `JAN JOAQUIN L;DUNTY 0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> EE + <br /> 600 East Main &t, Stockton, CA 96202-3029 <br /> Telephone: (209) 466-3420 Fax: (209) 464-0138Web: wWwe,Sjgov.OrglCInd q <br /> ,,0c cw5 PUBLIC RECORDS RELEASE APPLICATION <br /> ���?�` Bash Environmental,Inc. NAV iru T-r✓� <br /> APGP C 1:®&r5 t t#1 glr®et fluke S RUSINESSIAGENCY: <br /> ADDRESS: Oakland, Calilomla 94607 CITY/STATEIZIP: <br /> PHONE(1): 'JIG ibS41 010 al n PHONE (2)- FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: EEK ►'Z Time: 4 l <br /> (Pleaes allow 10 busln from date of appllc on submittal-*Tentative only-must be conflrmady <br /> ❑ CHECK 80X TO EXPEgIT UE 6 E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 8U51N/ESS DAYS <br /> SIGNATURE OF APPLICANT DATE � I / I s - <br /> Electronic Information: ❑ List❑ M p-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> ' Street# $treat Name Clty <br /> 1 [3unit 1 <br /> 2 yl- 2• MunIt2 <br /> 3. / <br /> 4. `Please respond as soon as possible. 1133unita �V <br /> 6, I need to notify applicant during week of 5/14/12 if <br /> EHD has files for listed addresses or not. <br /> $• ,p unit a <br /> 7. <br /> 8. 0 Unit 5 <br /> g. <br /> 1D. unita <br /> Speclflc Date Range of Informatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ff6um�RGROUHDTANK(UST)CLEANUP SITE(LOP) ❑HOUSINOABATEMENT ❑SOUDWA6TEFACILITYNEHICLE <br /> MW CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> NDERGROUHDTANK(MomrrORINOIREMOVAL) DO, ❑DOG KENNEL ❑DAIRY <br /> OOUS WASTE GENERATORS CHICKEN RANCH WABTEWATERTREATMENT PLANT <br /> IEREDPERMRTED FACILITY C�4L MOTELIHDTEL PLIMPERTRUCKIYAROIC40ICALTOILETS <br /> ❑TATTOOISODY PIERCING POfMPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL VYA6TE FACIWTY MPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the spate above. Select the type(*)of files from the list above by ahooking the approp Hats <br /> box(es). At least one fl le type MUST be sleeted. Fax to(2091 sea 019e or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 9:oo pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be conflnned approximately ten (10) <br /> days after reeelpt of appllcatlon. The thea will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 2. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganised by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review, <br /> 5' — Z: <br />