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D ECEIVED , _-_- �"' EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 2008600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.or h <br /> I T' <br /> QFC 'M--rR'.Vu- PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: The EC Group ED K_o_.J L� BUSINESSIAGENCY: <br /> ADDRESS: 201 East Orchard Street,Hammonton,NJ 08037 <br /> PHONE(1): 609-704-9990 PHONE(2): FACSIMILE: 609-704-9991 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> \� (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> 1A A) <br /> U 0\0 ❑ CHECK BOX TO EXPEDITE REQUEST-E f K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> D SIGNATURE OF APPLICANT i / DATE C % <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street# _ Street Name City_ ❑ Unit 1 <br /> 1. 845 East Charter Way(Pep Boys#710) Stockton <br /> 2. laaking r files rclalcd to a UST removal ❑ Unit 2 <br /> 3. LOP Case#1885-specifically a copy of <br /> any reports 01 Soil 4- L Unit 3 <br /> openedCase <br /> 6 / I O <br /> 7 �t o 1ff,/ Unit 4 <br /> ❑ Unit 5 <br /> IA A <br /> gElUnit 6 <br /> 10. yW <br /> Specific Date Range of In ormation Requested: From November 1996 to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ugj FiI <br /> '1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 13 SOLID WASTE FACILITYIVEHICLE f1 -ur }3^r <br /> Xy0 OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 WASTE TIRE ,/�. /ail 49T <br /> UNDERGROUND TANK(MONITORINGIREMOVAL�L ❑DOG KENNEL 0DAIRY Y'✓ <br /> El HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> TATTOO/BODY PIERCING ❑POOLISPA O LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-S:OOPM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 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 /> 3:00 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 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 /> 3. 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 reorganized by EHD staff at the expense of the applicant. <br /> -- Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> P. t. <br /> EHD 08-08 WEB 8/82007 <br />