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IVED Q1.=4 <br /> SAN NTY <br /> JUL 17 2014 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ��n 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �J <br /> ENVIRONMENTAL HFI hone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 4-LA �� ' s�-> BUSINESS/AGENCY: Fi t <br /> ADDRESS: t2 I'� Ttr ( (�lvc� . 5 rIG St�J CITYISTATE/ZIP: WAu'r C.V4-e- -i C44 "S`1-7 <br /> PHONE(1): 012x• `"1� • > Ui`I PHONE(2): rI 5"�• i f , 14 ) t 7 FACSIMILE: �l Z S . `7H fG. 1 ctLy� <br /> C(LY� Please allow 10 business days from date of application submittal forthe records to be available, <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> f( CHECK BOX TO EXPEDITE REQUEST- <br /> -$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> l <br /> SI NAT.U OF APPLICAN <br /> Electronic Information: ❑ List❑ Map-Description: -T",7 t.L + , �� 7� ; ALU A ' 7 I <br /> FILE ADDRESS EHD USE ONLY <br /> ok <br /> Street Street Name city / .! ., NQ <br /> 517t� <br /> S o c <br /> 1. J 10 <br /> S. moi ,. GFk Wr k� r <br /> 2. L-oa—Z'14-ca-j <br /> 3. `Tty 11 $ . �.' a✓-1 t tt V sT itinM CLAS /v <br /> / <br /> 4. [0/unit 3 <br /> 5! .,,� ..✓1 u: t l{ cc,5p <br /> ,1 6• Er unit <br /> L10 <br /> qt'© 2) 2 ❑Units <br /> E] Unit B <br /> Specific Date Range of Information Requested: From to <br /> �,/' ENVIRONMENTAL HEALTH DEPARTMENT FILES �je5 <br /> I wl uNj1ERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE I l� <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ^� 1 <br /> Liu DERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY El DAIRY <br /> ABOVEGROUND TANK F-1CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL. E]PUMPER TRUCKIYARDICHEMICALTOILETS �y <br /> ❑TIERED PERMITTED FACILITY ❑-POOLISPA ❑LAND USE APPLICATION SITES r+ <br /> ❑TATTOOIBODY PIERCING L�fOMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5: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 /> bpx(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.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records,please contact.EHD at the number noted above. <br /> 3. 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 btid held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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$125 deposit prior to review. "'*BOXED AREA-EHD USE ONLY*** <br /> -7 2 -W 096 L.L1ACtVc6da6 ia orDr.4 -5 . l2 <br /> UCbIl3clit UW 51H + ' T I Z C 0 Z 3 2ccu it n s 0 <br /> 31�1 b <br /> 3 9 1 Q ezh C6 �lDV ul! <br /> }� S Cbtxx.s�is k Cc tx r <br /> —,5--'7 W1 4lep"), 1-f -14, JxAx/, <br /> i - rPa <br /> t7flSinu.04 r'�iJ' 6 Ib�.(.1ac+-<n-�, - ft t T -1 r'O / en0. <br /> -�v � rk b`614Y�-�L XSJ -02y°19 Far Sc:�J A,rpa� qN . <br /> I �- p-el+lf -f)•CC7/' , iJ✓i cli(i IrTL.�Q(.in'f" ��+ <br /> k5J -61> �I 2CV-10 s*1m5C1A , Pv�Akl+ rp oP tam 5bm50A-tk->T InjrW, 5cW Alrpot� - Us'f PR-6z3/oc5 <br /> MOZ�lle4l 4 PK05b3yQ7, & 9io11 Air/9t1- •UST ,neWull, pr6Z31(, j SjoA kd g SDo-�.Airpaj- .i"hAn <br /> 1745 LlndllavAlvr :n {Ile nA nUP51M� _c1* <br />