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�m Mar/28/2013 12-'30-'52 PM Salem Engineering Group Inc. 4085771099 111 <br /> kms, <br /> ■ DATE RBGVED o EHD LOO NUMBER <br /> ■ �`� g�©�� SAN JOAQUIN COUNTY <br /> ` cry f ENVIRONMENTAL HEALTH.DEPARTME'NT � <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ql\ _` <br /> ,cfF (e�pKone: (208) 488-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> Y ,fI- <br /> APPLICANT: MAMA �u�alCGI�A BUSINESS/AGENCY: ' fAlLEM <br /> ADDRESS: qu 'xQ� Tow, 'We G CITY/STATE/ZIP; Saint K RSl�ll <br /> PHONE (1): ADD' fq '6 15 PHONE(2): FACSIMILE: S277. I QN <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only.must be confirmed) <br /> CHECK BOX TO EXPEDITE REE T-$126 FEE(GASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ma=l DATE o'bj%tZ0l3 <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street$ Street Name city ._ - Unit 1 <br /> F— � 1. � F�S� � _uLj" , l'fMj• ��M' „enUnl(3c� P <br /> J 2• D 11 a G l' N>d..y/ A)") (AU. 13 LQ � allnit2. <br /> r '13• 3 d19/Na t.V/y �M , <br /> p L/�/ <br /> 4, / v 1 � q �i N �7 iUnit9 <br /> 6. <br /> 6. R R R ER9 �� Unit4 <br /> To view the HMMP (Hazardous <br /> T Materials Management Plan) please <br /> 5' go to the following website: untt s <br /> 9. www.sjmap.org/hazmatviewer/vi'ewer.asp / <br /> 10. ..unit e <br /> Specific Date Range of Information Roqueated: From AWto <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE " <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT WASTE TIRE -2 <br /> UNDERGROUND TANK(MONITORINGIREMOVAL)C�- ❑FOOD FACILITY [:1 DAIRY <br /> ABOVEGROUND TANK l9 ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTE)HATARDOUS MATERIALS (/.. ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> TIERED PERMITTED FACILITY ❑POOIISPA ❑LAND UBE APPLICATION SITES <br /> ❑TATTOOIBO13Y PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 Am.5:00PM (EXCLUDING HOLIDAYS) <br /> 1. List up tQ tt9n addresses in the apace above. Select the type(s)of glaa from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464.0130 or Dail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications recelved after <br /> 3:00 pm will be processed the next business day, <br /> 2. The EHD will notify the applicant if any EHD flles exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for s 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 be <br /> submitted when the file la available. <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$126 deposit prior to review. +'k@4I .a YatEA�:�H U!S, C�TJLS <br /> , <br /> i, 4FIF <br /> steer:.'s provide . q ,Etta. PPf�i otmtY e�¢ s+attNramer, ? „ `,, <br /> EHol9.0e 914112 <br /> Received Time Mar. 28. 2013 12: 31PM No. 2694 <br />