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o: Pege30}3 20'13-02-'IS'{9:SO:55{GMT) laaaata�aec �rasrr. v:v::v:v�v::.:..e <br /> DAT` SVE EHD LOC NUMBER <br /> e� SAN JOAQUIN CIDUNTY <br /> 15 2013 68 East?Hazelton <br /> Avenue, <br /> HEALTH DEPARTMENT <br /> FEB 1668 East Hazelton Avenue, Stockton, CA 95205-6232,4/ <br /> E�tVBtON! 'r_R k fe. 9 <br /> ie' (209) SGS-3420 Fast: (2179'} 454-0138 Wets: www.sjgouofgiehtl <br /> r q <br /> � i„�gtTiyE1 1� W PUBLIC RECORDS RELEASE APPLICATION <br /> pn Q.fy_i (S BUSINESSIAGENCY: <br /> APPLICANT: ►� 1 t CL 6I <br /> ADDRESS: 1 S l7 TOS 1e(��,�I Ij x l 0- CITYISTATEIZIP_�lA(1 r l <br /> PHONE(1): '12-0— b 1`A 5� PHONE(2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: IL d — t^ y7 Time: <br /> (Please allow til business days from da of p ian�iun submittal-"Ferrtative only-must:le confimred) <br /> CHECK.BOX TO EXPEDITE.REQUEST-$125 PEE(CASHOR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: [] List 0 Map—Description: <br /> FILE ADDRESS — EHD USE ONLY <br /> Str001.IT Street Name Citic i Uri <br /> ViiI <br /> unttz <br /> 2, r�t..bou( tOn I_ <br /> 3. S ; <br /> UnNa y <br /> a. 575(0 , l <br /> ._ ..---- Unit 4 <br /> 5 To view the HMMP (Hazardous <br /> 8 Materials Management Plan) go to the _ Units <br /> 9 I following website:www.sjoesdata.org <br /> r0 Unit S <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT HUES <br /> O ❑MEkCALYA5TE FACILRY <br /> SV IDWASTEFACl IVEHICIE <br /> GJNMR0UIMTANK(UST)CLEANUP SITE(LOP) <br /> ❑HOusiNGABATEMENT ASTETIRE y� i�s !{1r J,t�9�}��. <br /> 7tdDERGRDUrdD?AfiK(MO'N70R7NG'.REfdD`dAL)(!\ ❑FOOC FAGILaTt ❑DAIRY 5- 94-3 <br /> CHICKEN RANCHI DOG KENNEL WASTEWATER TREATMENT PLANT <br /> ABOVEOROUNDTANK ik- - Puh7PE2TRUCldYARDIiHEMICALTobLETS <br /> HAZAnDOiis YIrASTF1HA2ARDDUB tAATERiALS� ❑MOTEtItstTfE` i]LAND USE APPLICATION SITES <br /> ED PERMITTED FACILITY Q POOR SPA E]OTHER(PLEASE SPECIFY) <br /> TATTDOIBDGY PiiRCIND �GDM.iAINTIRESPONS'c RECORD . <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. tyst up f4 ten addresses in the space above. Select the types)of fifes from the list above by checking the appropriate <br /> box(as). At least one fife type MUST be selected. Fax to(2091484-0138 or mall to the address Indicated above_ Address <br /> ranges wlit not be accepted -far additional aSSNIAncc with file addresses,Contact the EHD, Applications received atter <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD files exisL An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The fifes will he 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 whert file 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 5125 deposit prior to review. '";B(j1t,E -:; y,Kta : <br /> ., <br /> : <br /> , t <br /> a <br /> END 48-0e_. ' <br /> Received Time Feb. 15, 2013 11 :50AM No. 2326 <br />