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117 <br /> r { cEtu"ED' J SAIV JOAQUIN COUNTY <br /> JAN 21 2Utq NVIRONMENTAL HEALTH DEPARTMENT <br /> 1 8 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> EPEPMITI ERVICESep one: 209)468-3420 Fax <br /> (209)4640138 Web: wwwsjgov.org/ehd <br /> �.' L <br /> i �,� ,4 — ` LIC ECORDS RELEASE APPLICATION jj <br /> P-jr r <br /> �CAPPLICANT: VictoriaJordan , ' ( BUSINESS/A NCY: Kleinfelde/I /'71'[� l <br /> ADDRESS: 2001 Arch Airport Rd. Suite 100 -`�`SCITY/STATEIZIP: Stockton CA 95206 <br /> PHONE(1): (209)469-4375 _ PHONE(2): (209)948-1345 FACSIMILE: (209)234-4700_ <br /> TENTATIVE'APPOINTMENT DATE: Time: ff <br /> MHN Pease atlowl business days om date ofa licationsubmiHal-'Tentative9nly-mustb ce onfirmedl DY <br /> (BOX EXPEOIT EQ E $1 EE(CASH CHECK ONL REQUEST\PRC96ESSED\IfR`S,4USIN SIDPJY <br /> Sri- <br /> SIGNATURJ �CANT DATE /- /y- <br /> Electronic Information: ® List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> ®� Street# Street Name h ❑Uni <br /> F32Qe <br /> -)f II 3 ❑Unit 2/�1 tl 'jam G/ I�ni 3 <br /> CES at4 <br /> .. 7. a �� /t 0 ,A7fI MM No <br /> e 3 8 d( /'%�❑Unit 6 <br /> O 1f) <br /> to <br /> 10' <br /> 3� 10. -jr) <br /> l nits <br /> Q F Specific Date(Range of Informatlo equested: From e <br /> vv ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> O � <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E]MEDICAL WASTE FACILITY ©SOLID WASTE FACILITYNEHICLE r/, �t;T>. <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT E]WASTE TIRE q file-5 (, <br /> .�' '-P ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY r-ig <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> gN ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL E]PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> 1 r—tt ®TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATroolBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> O 9 N WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> c 5 <br /> 21. 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(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the address indicated above. Address <br /> N e—�, 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 /> NLCI? 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> i. lb 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 /> t3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> cS`A submitted when the file is available. <br /> EHD <br /> _. ® o maicant <br /> (.4 Any Future file <br /> file reviews ed in the same by the same applicantion as released will be reorganizemay require a$126 deposit pr ortoystaff at the BOXED AREA-EHD Uhe SE ONLY -- <br /> r <br /> b-I Ll <br /> © t4 g d SI (0 <br /> S4 QaIP4 o- _ Aqbya us r, <br /> s les 911%)50n2 <br /> EHD 8.06 /I f)D(J (.Ohl $ 5�(pj(QrovbS89bq a•y-4-to,C) X91 fr. 911%) <br /> 4-8 -9-7( a le n t+w�le JOS 400 Un coin. gee Mc�e t v lcwsil o b,i KMr Yj <br /> Lloo Unco lima'(PFI�• d�dcopy afcot�2zAzY�pk s(ole.-Wit -CA,-+) r 735 s�c{fk a�? =Q <br />