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E,6 CEt'ED!R'V� �)4A-� EH <br /> N JOAQUIN COUNTY <br /> JAN `) ZOIk, NVIRONMENTAL HEALTH DEPARTMENT <br /> 1 8 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMEPtTALWEN{4(1ap One: 209) 468-3420 Fax: (209)4640138 Web: vdwwsjgov.org/ehd <br /> PERMIT/ ERVICESI ,V _. <br /> ,a ?�. 4— CucL LIC ECORDS RELEASE APPLICATION ) <br /> r f , �� �• Kleinfelder~ <br /> Q" APPLICANT: Vict0 a or , BUSINESS/A�g NCY:' <br /> I / /7f�n � <br /> ADDRESS: 2001 Arch Airport Rd.,Suite 100 r`96CITY/STATE/ZIP: 86kton CA 95206 <br /> PHONE (1): (209)469-4375 PHONE(2): (209)948-1345 FACSIMILE: (209)23411700 <br /> TENTAT/VE'APPOINTMENT DATE: date of ap fication submTime: <br /> (Pse allow 1 business days om ittal-`Tp <br /> entativenly-must b c@ onfirmed <br /> [ H B <br /> SIGNATUPEDIT �Q E $-- 1 EE(CASH CHECK ONL EQUEST\PR.66€SSED\IN'9•�USIN D Y � U <br /> RE O PPL CANT 1 DATE /- 1,Y- /t/ <br /> c; <br /> Electronic Information: ® List❑ Map-Description: <br /> FILE ADDRESS _ _ EHD USE ONLY <br /> Street# Street Name city ❑Uni <br /> 04 __:1555 5 i- nr,�ltl- r NO <br /> UA, 3 I Un 3w <br /> ,() ^� 2. I : It • OUnit2 <br /> IL A <br /> 4• � <br /> tL r71 l l�ni 3 <br /> 5. <br /> _6. / - e.7 to <br /> ^ "3 O 7 a It D IAr5ll MM No��Jj/ <br /> Unit 5 <br /> boq 9. J / <br /> 3� <br /> rj 4 Specific Date7Range of Informatio eques <br /> EN From ° <br /> � � ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> fU is Cj ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ©SOLID WASTE FACILITYNEHICLE <br /> ro <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT 1:1WASTE TIRE q <br /> y,� V ILI <br /> 9 ®UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DAIRYFOOD FACILITY ❑ �'- <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ' •�N ®HAZARDOUS WASTEIHA3ARDOUS MATERIALS ❑MOT ELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> g 'n M TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOBODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> O P �� WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> c s <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 /> box(as). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> N r Z ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> r _17N 3:00 pm will be processed the next business day. <br /> `fir'/qL lC�� V\ 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> So days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> IA^ 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 /> vJ r submitted when the file is available. <br /> g7 34. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> 'T M " .b Future file reviews by the same applicant may require a$125 deposit priorto review. "'BOXED AREA-EHD USE ONLY -- <br /> 'T 0 � r s <br /> N5 I / <br /> i � sO o- . 1 rzz S k� X12 <br /> _ O r <br /> EHp 48-06 (/ /I fL(� Lt)✓31 ` 5"��l Ca,'0001 / 896q Q- 701�) gll�i �1 (0), <br /> o-86-yy((te le ) n rWMe dpi q00 (incoI Iw }ride t.u'tfw�l ,l �► r <br /> L(DO UAWji7n I-WA'IP'99 _ '� copy tr(cozaZLI'fA 5twfle-Spit feparl-� r 735 4;nu <br />