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07/03/2012 10:07 FAX 559 442 5081 KLEINFELDER a002/002 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd10p <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ke'n 1,U1,(If a BUSINESS/AGENCY: ILLean Fe(��r <br /> ADDRESS: �jl2Cj t`I Gnkes pcVL CITY/STATEOP: t�Y P�YLU( Cp, q,�j ]aa <br /> PHONE(1); �R 45(g 6-iso PHONE(2): 550( Qll¢ (((.0-2 FACSIMILE: �q gz6CF`r <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submM-1- TerdaUve only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _ DATE s`tR/Zp�_ <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD use ONLY <br /> StreetA• Street Name city <br /> 2.1wi5F'6'5"6'1, ❑unit 1 <br /> �`� 22✓Gil f". .�QQ- � � NJ <br /> 2. <br /> /c/o IL rI 54 <br /> 3. <br /> 5 N7Un;{3c0/ unnz <br /> �� 0 L��II (S�('Ir»ea <br /> __/ �I z r �nH3 <br /> � 5• �i , .� �� S vt T IJ�l <br /> 6. µ <br /> 7. �J _/Gv ��>r ubna <br /> 8. B�� <br /> s �.� �. .-''fr.:f�� o G V'^fi <br /> ❑Unit 9 <br /> nn Specific Date Range of Information Requested: From to <br /> �'1 ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> U ERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑$OLID WASTE FACT'III-fff111"""IYYYNEHIYC,L�E /' - <br /> fn �y,OyTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WA$TE TIRE 15 C,I P_2 I�� I�3• <br /> _ Yr�J�UNDERGROUND TANK(MDNITORINGIREMOvAL)oL ❑DDG KENNEL ❑DAIRY -7- n„�2 <br /> O- DiiAZARDOUS WASTE GENERATOR -7- <br /> CHICKEN RANCH ''11 <br /> >- WASTEWATER TREATMENT PIA <br /> 110 �Q TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEMICAL T00.ET�•� <br /> �l,U TATT00)BODY PIERCING ❑POOLISPA <br /> Ml El LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY 'COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> SS WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:ODPM(EXCLUDING HOLIDAYS) <br /> �F� f. List u to ten addresses in the s ace above. Select the A <br /> P types)of files from the list above by checking the appropriate <br /> box <br /> (es)• At least one file type MUST be selected. Fax to(20914640138 or mail to the address Indicated above Address <br /> S5 ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after n Z <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 a � <br /> approximately ten(10)j <br /> days after receipt of application. The Tiles will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> y 3. A file that is actively being worked on by EHD staff ma notZinediately available for review. A new appllcati maybeNsubmitted when the file Is available. ' -b 3Any file not returned in the same condition as rete ed wil re rganized by EHD staff at the expense o e applicant. <br /> Future file reviews by the same applicant may re ire a$125 deposit prior to review. - (� <br /> t' _HOUSE <br /> ( a N <br /> LReceived Time—Jul. 33 2012-11 : 04AM_No. 01297-11-17' ' CD09a73'0 (� <br /> a i^ kpll, WArV_ % 3q 3Z 1 �1 K8 er,„ <br />