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iv.ur r� DDa 44L Du61 KLEINFELDER 0002/002 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY ~' EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 101%q <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ILP,Y` l U161GY BUSINESS/AGENCY: IC-LYtn nd,&r^ <br /> ADDRESS: rj(05 R Ga-+es Nvc- CITY/STATE/ZIP: F-rano lQ� Q37aa <br /> PHONE(1): e5R `faLp b-(gyp PHONE(2): 550( RILg (L(oZ FACSIMILE: 55cl q4Z - i<j <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of a Ilcatlon submittal-' Time: <br /> Y PP Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTDATE zpz <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name cm, <br /> r SffRi . . / ti.� ❑unffl <br /> K 2• /a/o Ii f� <br /> �� NJaA (3C0/`'UnH2 <br /> 3. � Gntl�(iPC <br /> �1�� ��_ ANO LJ <br /> 4. <br /> L g, f I Unk3 II <br /> / E6I L �, , ✓ �( 1A T L� l 5� IJi LDl'7 <br /> r i <br /> 7. �O �' /f � punit4 <br /> R � (✓5,L0(Llr <br /> 9. Si c. �P:;cr..:f 0 5 G cLn 3 u7it� una5 <br /> i <br /> m 10. <br /> nn Specific Data Range of Information Requested; From El Unit 5to <br /> 'I ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> '"-pU DERGROUND TANK(UST)CLEANUP SITE LOP ❑SOLID WASTE FACT NEHI LE <br /> n1 (LOP) El ABATEMENT I G I E �iL /' - <br /> M OTHER CLEANUP SITE(NON-LOP) ❑FODD FACILITY ❑WASTE TIRE .5 ((f/� L(/71��- <br /> _ I�'�UNDERGROUND TANK(MDNITORINGIREMOVAL)OL ❑DOG KENNEL ❑DAIRY �,,�7 <br /> tS [?' AZARDOUS WASTE GENERATOR i� ❑CHICKEN RANCH Y_; J' <br /> S 0 WASTEWATER TREATMENT PLANT <br /> ❑❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS, P <br /> Q^I TATTOOIBODY PIERCING ❑p00L/SPA 'e-1. <br /> fyl MEDICAL WASTE FACILITY ❑LAND USE SITES <br /> 2-COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) v <br /> pc WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY$:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List u to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate ); '1 <br /> sbox(es). At least one file type MUST be selected. Fax to 1209)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 <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 -`zreview will be confirmed approximately ten(10 <br /> days after recelpt of application. The files will be held for a maximum of five business days for review. Appointments_ �� <br /> q} should be scheduled accordingly. <br /> A file that is actively being worked on by EHD staff me n`o`;�4yE im ediately available for review. A new appllcati n may be N <br /> submitted when the file is available. I !( (T Le <br /> Irrl I� b , g c <br /> c3 4. Any file not returned in the same condition as rete ed Wil b re r�nized by EHD staff at the expense o he applicant. I <br /> Future file reviews by the same applicant may re ire a$125 deposit prior to review.ft <br /> - r <br /> ' - Z TO D USE , <br /> s roll h e172f 3 i -7 rGb <br /> y <br /> irl)Al r, <br /> ERece_i_ved ltm'ie/-1 Juul, 3­20 2-11 : 040—No. 01291 -IZ <br /> TVVl ) �OfkJ�73p S �L/ n <br />