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J/12/2014 4:09 PM FAX 1415541939 TRC SOLUTIONS INC 2001/0001 <br /> i <br /> EHD LOdIUMBER <br /> EGE■� k_, SAN JOAQUIN COUNTY <br /> ` ���� u AT �� <br /> ■ ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAR 12 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)4640138 Web: www.sjgov.org/ehd <br /> VIRONMENTAL HEALTH <br /> P M1V5EMnCES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: (,O K BUSINESS/AGENCY: ���;ror�d►'1!+'►�° <br /> ADDRESS: 10 Z& i - 00 CITY/STATE0P:Sa,-t,_f-}rr .,�j( .l`SCn CJ4 9Li iOS <br /> PHONE(1): q 15— Gw y-30yj9- PHONE (2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE:Mo_rC,),, Z , 7=01H Time: <br /> (Please allow 10 business days from date of application zdbmittal-"Tenudve only-must be Confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CAS_H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Descripti <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City 6�.-�. Unit 1 <br /> -.... <br /> i n n <br /> 2. tc )1 (L 11 (+ � 1M�1 tieCCf;_ Unit2 <br /> 8. Z.. -- <br /> 3- <br /> 4. Unit 3 <br /> 5. <br /> Unit b <br /> 8. _ �. Unit 5 <br /> 9. <br /> 10. [:Unit e <br /> Specific Dots Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> [�NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WAsTE FACILITY ❑ UD WASTE FACLITYNEHICLE <br /> ,OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT �ASTETIREEROROUND TANK(MONRORINGIRET�IOVAL) ❑F000 FACILITY ❑DAIRY y <br /> �ERGROUWD TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAzARDous WASTEIHA7ARDOUS MATERIALS ❑MOTELJHOTEL ❑PUMPER TRUCKIYARD/CHEMK Al TOILETS <br /> ❑MERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPL3wiom Sns <br /> ❑ I ATTO011;3OOY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEMII: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HoUDILYS) <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(es). At least one file type MUST be selected. Fax to(209)464-0138 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 files will be 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 <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized,by END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ,_BOXEo'AREK]EHD``USE(ONLV <br /> El Records provided by-Starf=PPR,Corn 0fete. SfaffName: <br /> Received Time Ma'r.12. 2 01 4 5 : 07PM No. 5414 WIU12 <br />