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®� DATE RECEIVED � � f ` � '� EHD LOG NUMBER <br />'lay SCAN JOAQUIN COUNTY <br />9Big ENVIRONMENTAL HEALTH DEPARTMENT <br />RECEIVE® `, Q <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232�h <br />SEP 0 3 2015 Telephone; (209) 4BB-3420 Fax: (209) 464-0136 Web: www.sigov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />ENVIRONMENTAL <br />Afi"MW $t3E$ Racco BUSINESS/AGENCY: Live Oak GeoEhyironmental <br />ADDRESS: 407 W. Oak St, CITY/STATE/ZIP;,atfi CA 95240 <br />PHONE (1): (209)369-0375 PHONE (2): (209) 365-3222 FACSIMILE: 369-0377 <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to arrange an appointment date and time to review the requested records. <br />Igo <br />® CHECK BOX TO EXPEDITE REgUEST - $ FEE (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT /�/j� DATE `3 `I S <br />Electronic information: ❑ List ❑ Map — Description: <br />Street # <br />FILE ADDRESS <br />Street Name <br />City <br />EHD USE ONLY <br />❑ Unit 1 <br />�• <br />550: <br />W. Fro vert Rd. <br />Lo.410 <br />NFt' <br />61"it2 <br />2, <br />z CvSi S, t 11 @ <br />r <br />y <br />Lam -/171 unit 3 <br />4.. <br />14((R W• Kia <br />S. t�%lGM �� t <br />T <br />��J ��" Fps cw(�" G7' J I L4"- <br />12Unit4 <br />7. <br />ZrFfv oZ� <br />.V . EI I i a YI— <br />GvA+- Ou C <br />.I V ula .�Alty w•,OL c+Pkty <br />f0 ilnit 5 <br />C _+kwd <br />9. <br />Speclflc Date Range of Information Rtquested: From r Gi,u a.. iLabLt.Q. to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY ❑ SOLID WASTE FACILITY/VEHICLE <br />.OTHER CLEANUP SITE(NON-LDP) ❑ HOUSING ABATEMENT ❑WASTETIRE <br />UNDERGROUND TANK(MONRORINO/REMOVAL) ❑ FOOD FACILITY ❑ DAIRY <br />ABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br />HAZARDOUS WASTEIHAZAP.DOUS MATERIALS ❑ MOTEL/HOTEL ❑ PUMPERTRUCK/YARD/CHEMICAL TOILETS <br />TIERED PERMITTED FACILITY ❑'POOL/SPA ❑ LAND USE APPLICATION SITES <br />TATTOO/BODY PIERCING COMPLAINVRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />1. List un to ten addresses in the space above. Select the type(e) of files from the list above by checking the appropriate <br />box(es). At least one Mle.type MUST be selected. Fax to (209) 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 END will notify the applicant if any END files exist, An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will ba 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 END staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $125 deposit prior to review, t"@OXED AREA -EHD USE_ONLY"" <br />,'04et 91OG A,d MR tLv lb;.t G O of I kl R ry C re {at <br />7, 0 nn I15G5 r'1w v1' Rm,,N0AIp112 I^ R . <br />0 Records provided by Staff -PPR Complete. Staff Name: <br />FHM1AAn. <br />41'18/14 <br />Received Time Sep. 1 2015 10:51AM ND.9483 <br />W}M <br />�c*I r.�!Gih <br />