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06/28/2013 09:00 9167860366 LFR F1 " C.f: <br />°s U <br />VOW <br />DATE RECEISEo SAN JOAQUIN COUNTY <br />. ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />- -Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: Vww.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />EHD LOG NUMBER <br />APPLICANT: SttSAW c) fRiGiGLAri� BUSINESS/AGENCY: /CK.WWV-I-N <br />ADDRESS: 1000 Gt)B[3 UID�w,B CITYISTATEOP:K <br />��OEj PHONE (2):��I FACSIMILE: �I70• rB. N"O <br />PHONE (t): Time: <br />TENTATIVE' APPOINTMENT DATE: <br />(please allow 10 buslneas days from dam Cf appjcadon submittal-'Tentaava only- must be firmed) <br />gyp{ Gt:a( BOX TO EXPEDITE RE ST - SI FE (GASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />A , i_U-VG IA. d DATE to'Z-$•I3 <br />SIGNATURe <br />Ur <br />Electronic Marination: ❑ Lisin Map- Descriptlon: <br />EHD USE ONLY <br />U� i �I� M , ;coN� <br />FILE ADDRESS <br />F <br />•s a 1 Street Name City <br />Ro •i -h fl <br />% <br />1. l <br />�.__.' + ro <br />unit <br />2. <br />l Ddl% PI h5 <br />3. <br />eY <br />4.�ZBV►1T7�f4A <br />unit3 <br />5. <br />c , <br />0rt- <br />�1nh4 <br />6. <br />�"rCU <br />OVti s <br />7. <br />8 <br />0 Unit 5 <br />9. <br />10. <br />r <br />'r <br />❑ Unit 6 <br />n v <br />1 fe <br />SpeCMk Dila. Aara W Mawnaaon nequesaa: r•.+.11 - - <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />IUNDWANAM Taal((tfM CLEANUP Sim (LOP) ❑ MEDICAL WASTE FACILITY ❑ SOLO WASTE FACI�LNIV LE <br />OTHER Ql/WIJr ffrE(IR)MLOP) L] HOUSING ABATEMENT ❑ WASTE <br />1 "�l (f' 7Q! <br />Eo) <br />ROIaAaCTAMPCIMTORIWREMOVAL)1T' ❑FOOD FACILffY ❑DAIRY. -7-1;IEOaOiaD Taw O'- ❑ CHICKEN RANCH] Doe KENNEL ❑ WA6TEN/ATERTREA7MENr///pl]]]/// / <br />WAErjHAZARDOUS MATERIALS ❑ MOTELIHOTEL !• / <br />POOLISPA ,i <br />TATTOOGODY PIIRCINGI ❑ ComPLAINTIRESPoNSE REcoR[ I <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRV,,.!/�t/�-`Q`''om-''(�T�'fy� <br />1, in the spat® above. Select the type(s) flus from i <br />box(es). At haat one file type MUST be selected. Fax to (2091466 4-0138 or m IN <br />ranges WW not be accepted" for additional assistance with file addresses, cc 0 <br />3:00 pm will be processed the next business day- s _ 'O <br />— <br />2. The EHD will notify the applicant if any EHD flies exist. An appointment for n UY� <br />days after scheduled <br />le application -ding) The files will be held for a maximum of flue I 'N` �. <br />should be sdwduled aceordingly. <br />3. A file that is actively being worked on by EHD staff may not be Immediately at <br />submitted when the file is available. <br />4. Any file not returned In the same condition as released will be reorganized by <br />Future file reviews byitha same applicant may require a $125 deposit prior to Icv,ew. eWACul70iC A ttINSIrSEiOrtLLY <br />1-11LX/ I f U Vvtn, . . w , - r . - c . ,.. r , , v o - - <br />Received Time Jun.2 . 2-13 -- --A No. 3484/(fgde5l.ed',1 <br />