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REAMED <br /> SAN JOAQUIN COUP F-a <br /> JAN 2 4 2012 ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main St. Stockton, CA 95202-3029ENVIRONMENTALHEALTI-)Telepho e: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMIT/SERVICES <br /> UBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jacob Amen BUSINESS/AGENCY: Weber, Hayes &Associates <br /> ADDRESS: 124 Weslgel Drive CITY/STATE/21P: Watsonville, (:A 95(j76 <br /> PHONE(1): R31-72_>>-35li( PHONE(2): FACSIMILE: 831-722-I 159 <br /> TENTATIVE'APPO NTMENT DATE: 1/27/2012 Time: 2:00 PM <br /> �ipqI (Please allpw 1 business days from date of application Utn"Idal-'ronfef/vo only.must be confirmed) <br /> qi CHECK BOX TO FXPF ITE RFOUFST-¢175 FEE(CAS OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAY$ <br /> SIGNATURE OF APPLIC NT DATE i 2-4 i- 1I <br /> Electronic Information: Q List Map-Description: <br /> .._._ __.._ FILE ADDRESS EHD USE ONLY <br /> Stroot p Slrcdt Namc Cay <br /> it t <br /> 1. 2712 East Fre )on[ Street Stockton UST f - <br /> 2. 2760 East I?rel Ont Street. SuxkUm �0/ Unitz <br /> -- <br /> I 3. 457 North Sh Ista Avenue F Stockton (J NO cO/e <br /> .... <br /> 4. 21155 EeseMilcrAvc Stockton 06S; N�I.D�P_. eons <br /> 5, 2715 East Mi er Ave r Stockton IU0 t NO LO <br /> 5. 2630 East Fre unl5hcA) f; Stockton � (p y� �Ita. <br /> -- - �(�TryJ <br /> 7. 2517 fast Pre nont Street N f Stockton NO t,U1i� 3 CLPiPO L Aik3 y <br /> p <br /> S. 2550 East Fre front Street Stockton O (j/1i'� Zj(,' O�j3 Unit 5 <br /> -._. <br /> 10. SM <br /> r- <br /> 9. t. <br /> nit 8 <br /> Speolfic Date Range of Informatia Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 2 <br /> UNDERGROUND TANK(UST)CLEAN P SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE 7 f <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE . <br /> UNDERGROUND TANK(MONITORIN REMOVAL)V— ❑DOG KENNEL ❑DAIRY L <br /> HAZARDOUS WASTE GENERATOR in5poolion5/)K ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT 1 �� <br /> TIERED PEItM11T'ED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RE OROS ARE AVAILABLE FOR REVIEW' MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List UD to ten addresses in a space above. Select the type(s)of files from the list above by checking the appropriate <br /> boxies). Al least one file ty a MUST be selected. Fax to(2091464-0134 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHE). Applications received after <br /> 3:00 pm will be processed t e next business day. <br /> 2. The EHD will notify the appl cant If any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of applies ion. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accor Ing[y, <br /> 3. A Nle that is actively being orked on by END staff may not be Immediately available for review. A new application may be <br /> submitted when the file Is a aliable. <br /> 4. Any file not returned In the arae condition as released will be reorganized by EHD Staff at the expense of the applicant. <br /> Future file reviews by the s me applicant may require a$125 deposit prior to review. (� <br /> iq7q1 O 0 <br /> r V <br /> EBD M-aa Willi <br /> 2,2'd 8210179t,602:Di :woad L£:eo 2T02-b2-NUf <br />