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Mfr '6 <br /> REGSI,Jc�y <br /> GLS SAN JOAQUIN COUNTY ^ .�w ,�� <br /> QSTO1S <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ` `_J <br /> 0,0 1868 East Hazelton Avenue, Stockton. CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.Or9/e!0771i <br /> 1ERVIGpMfflN9WALHEAL� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 1 BUSINESSIAGENCY: <br /> i/ <br /> APPLICANT: -ot Rtnt <br /> ADDRESS: rte' 1�dV l7r ynr. loo \ CITYISTATEIZIP: „nPK rsA 96H15 <br /> PHONE(1): 616 z PHONE(2): FACSIMILE:�rglb�&(6D-6603 <br /> TEN ATI E'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data o appllciitlon submittal-'Tentative only.must be confirmed) <br /> [�CHECK BOXTO EXPEDITE REQUEST- 25 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �-� DATE t)2ja4ar <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS p END USE ONLY <br /> Street p Street Name City f� Unb 1 <br /> V 1• 'do fur I _.. Lal: Hv� aJN nctc�sp <br /> JVVV 2. ( } r�ue� tJe coS Unit2 10 <br /> Ua 3 . s n1LcoSP <br /> 4. C r rbQ� "Oc SUnit9 <br /> 5. � <br /> FIMr �GCU � <br /> G. tlo FaS1 Turner Lcol: p'6nit4 <br /> 7. <br /> CD s <br /> g. a Units <br /> 9. <br /> 10. Unit s <br /> Specific Date Range of Information Requosmad; From cel o to 'DK56n <br /> �,,� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> zi✓ ;aERGROUND TANK(UST)CLEANUP SITE(LOP) �EDICAL WASTE FACILITY 2 ID WASTE FACILrryNEHICIP f I)ie> <br /> HER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT [�STE TRE 10 Cpl y] <br /> ERGROUND TANK(MONRORINGIREMOVAL) ❑FOOD FACILITY ��(AIRY 'k(,x `'17 <br /> BE: <br /> VEGROUND TANK ❑C ICKEN RANCH/DOG KENNEL 2rrASTEwATERTREATMENTPLANT P' ' <br /> RDOUSWASTEIHAZARDOUSMATERIALS W(TEL/HOTEL MfOPER TRUCK/YARDICHEMICALTOILETS <br /> 6ZAIERED PERMITTED FACILITY l�J-160O ISPA � USEAPPLICATION SITES <br /> ❑TATToo1EoDY PIERCING PuOMPLAINT/RESPONSE RECORDS UZER(PLEASE SPECIFY) QN�N " <br /> WELL AND SEPTIC PERMIT RECORDS ARE AYAR.ASLE FOR REVIEW: MONDAY-FRIDAY 8:00 AAt-5100PM(EXCLUDING HOLIDAYS) toWictn <br /> 1. List up to ten addresses In the space above. Select the type(a)of files from the list above by checking the appropriate <br /> box(es). At least one filo type MUST be selected. Fax to 1209)404-0135 or mall to the addreaa Indicated above. Address <br /> ranges will not be accepted-for additional assistance with Nle addresses,contact the EHD. Applications received after <br /> 9:00 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 /> 9. A His that Is actively,being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expanse of the applicant. <br /> Future file reviews by the same applicant may require a S12S deposit prior to review. <br /> i zn a nn a.'. m r 1+ia <br /> k •i..x,.?�tvajnl t . 9 Y4V'1i "..m .li°'�ti f;'^.til . 1 4 _. Vin. iI?,-e� <br /> G <br /> d: . e�. <br /> tui •;,,. :,; .Y: <br /> ENO peas <br /> �i <br /> vuJ 7c'71 circ/en/ni. v <br />