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12/02/2014 14:52 5624321',P!,; KLEINFELDER PAGE 01/01 <br /> sem; EHO LOG NUMBER <br /> pAr ,� t SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT ^ r <br /> DEC 0 2 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �} <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov,org/ehd t ir <br /> ENVIRON <br /> ttv,ENtA HE^,LrI.PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ma garetCarroll BUSINESS/AGENCY: Kleinfeider 4 <br /> ADDRESS: 620 West 16th Street,#F CITY/STATEOP: Long Beach CA 90816 <br /> PHONE(1); 562.432-1696 PHONE(2): FACSIMILE:662-432-1796 <br /> Please allow 10 business days from date of application submittal for the records tebe available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS, <br /> SIGNATURE OF APPLICANT �jCnll"A 1AA% Cac i gA DATE December 2,2014 <br /> I.ElootronicinforTnation: 0 List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> StreejB Street Name city Unit 1 <br /> 1. 7544 W. Eight Mile Road Stockton ODP <br /> 2. 6210 Westlake Drive Stockton p N "o <br /> 3. 6712 Cherry Port Drive IV, Stockton 0APJ, ;v, :ut-A �� t <br /> 4. 10599 Regatta Lane , , Stockton lets 641. Unna <br /> <rQ 8090 Rio Blanco Road Stockton vi <br /> 6. 8095 Ric Blanco Road Stockton ,.4' UuFt4 �) <br /> 7. <br /> 8. <br /> ❑unit 5 <br /> 9. <br /> 10. ❑Unit 6 <br /> Specific Date Range of Information Raquastad: From to <br /> ENVIRONMENTAL HEALTH DEPATMENT FI ES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACLITY ❑SOLID WASTE FAcILRYNt]UCUi ( <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE`rL ft le 6-, 1 L-D <br /> UNDERGROUND TANK(MDNnoRING/REMOVAL"` ❑FOOD FACILITY ❑DAIRYt y'•}( '}i- <br /> 10 ABOVEGROUND TANK %- El CHICKEN RANCH(DOG KENNEL �WASTEWATERTREATMENT PLANT <br /> HAZARDOUS WASTENA7ARDOUS MA7ERIALSy ❑MOTELIHOTEL PUMPER TRUCKIYANDICIEMK:AL TOILETS <br /> TIERED PERMITTED FACiuTY,71- ❑POOLISPA ❑LAND USE APPLICATION Suras <br /> ❑TATTOOIBODY PIERCING WCOMPUUNTIRESPONSE REcORDs ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of filesfrom the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(109)464-0138 or mall to the address indicated above._ Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. 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 /> 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$130 deposit prior to review. "*BOXED AREA-EHD USE ONLY"" <br /> IGT iS ,Dai r v I tJ (ttrt' �S �r <br /> fl� , .r - zZrC ! - Lie '� Fi�M•A)"WI ,, 1•,.. <br /> r $r s cif 10(> az,K�I X)ZXe2✓0 11 4r <br /> c- <br /> Rece v, J 7 m ec 2 1 2: 30PM No 7642 ' RFs "t`t uav (o rr'i�lo� � ti � <br /> 1-1045• UXIC,"(&OILL i�^39t 1, n ; p <br /> t4h(M,0S4bZ) /fE?- K• ' <br />