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((jj 032013 11:16 13106709512 - THE PLANNING CENTER PAGE 02/02 <br /> 8"`7i I(t'� @ D r EHD LOG NUMBER <br /> f 'rm SAN JOAQUIN COUNTY <br /> MAR 15 2013 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton,CA 95205-6232 <br /> EN1r18f3NsEfUTALHt piTlelephone: (209)468-3420 Fax: (209)464-0138 Web: w9vu.sjgov.org/ehd <br /> PEWAl;/GERIi7GE;i <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ,CASLl- 11SO1aN\3prUG'14 BUSINESSIAGENCY:T�,V OY�t1t�f 0 1}4! 17C�>; <br /> ADDRESS: q$r{ � $4r 0r�'�►��I SI'-� 1G16 CITYISTATEl21�: <br /> Q - }23 S•v...e. 1<ro,v31.QQlouat�c5ca� m+•- <br /> PHONE(1): 3t< j _p ZZ L e+ • P440NE-P): FACSIMILE:3I4'G 1 g S 12 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-•Tentetive only-must bo confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REOUE T. 5 FEE(C SH R CHECK ONLY)-REQUEST PROCESSED 1N 3 B SINESg DAYS <br /> SIGNATURE OF APPLICANT DATE 3 1 S~I 13 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name City ,�]Unit1 <br /> 1. 25 b I 1 atfi4rsa—tT7c­,537Trar u , coj <br /> } 2. pavKke;t, W10.0 1 t 4°1 t ❑Unit <br /> 3. <br /> 4 Unit 3 <br /> 5. 5 <br /> 6. Unit a <br /> 7. <br /> 8 ❑Unit 5 <br /> 9. . <br /> 10. 13 Unit 6 <br /> specific Date Range of information Requested: From to <br /> ,/ ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> oaf <br /> TANK(UST)CLEANUP SITE(LOP) ❑MEDICALWASTE FACILITY ❑SOLID WASTE FACT EHII.C�LLE� „ <br /> M' ER CLEANUP SITE(NON-LOP) nn�� ❑NOOSING ABATEMENT ❑WAsTETIREy � ,vwll�� <br /> R,_,,,,�DERGROUND TANK(MONrrORINGIREMOVAL)v, ❑FOOD FACILITY ❑DAIRY -5 _2y-F5 <br /> SOVEGROUNDTANK � ❑CHICKEN RANCHI DOD KENNEL ❑WASTEWATER TREATMENT CANT <br /> ❑HAzmDous WAsrEfHA7ARDOuS MATERIALS ❑MOTEtIHOTEL ❑PUMPER TRUCKIYAROICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATToOIBODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Ara-S:ODPM(EXCLUDING HOLIDAYS) <br /> 1. List uo to en addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209) 64.0138 or mail to the address Indicated above. Address <br /> 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 review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A rile that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the 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$125 deposit prior to review, "'BOXED AREA-EHD USE CILY••• <br /> L = rdvo P r o <br /> (f7 CDD r S d .t 79 Jr L <br /> ❑ Records provided by Staff-PPR Complete. staff mama <br /> ...eu 914/12 <br /> Received Time Mar. 15. 2013 11 :25AM No. 2561 <br /> TDTFL P.01 <br /> s ; _ <br />