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-234-0538 Line 1 01:47:30 p.m. 11-2/-lOt lU LUU NUMBER. <br />DATE RECEIVED ,r SAN JOAQUIN COUNTY <br />RECEIVED ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />OV 2 7 2012 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />'INMONMENTAL HEALTH <br />rPERMMSERVICES PUBLIC RECORDS RELEASE APPLICATIOON' ^n �7 <br />APPLICANT: 41,0,Xbe—W %% BUSINESS/AGENCY: /Vkw �� /P <br />ADDRESS: /0'9� `2XX)k lG ��� CITYISTATE/ZIP: 5m,10i il'-A <br />PHONE (1):�� l%/��g PHONE (2):6D/4 6�i� �� FACSIMILEM-041'-673-3 <br />� <br />TENTATIVE* APPOINTMENT DATE: Fr) / Py -90 Time: 4AA1 <br />(Please allow 10 business days from date of application submittal .-Tentative only -must be confirm d) <br />CHECK BOX TO EXPEDITE REQUEST- EE (C OR CHECK ONLY) -REQUEST PROCESSED IN 3 BU (NESS DAYS <br />SIGNATURE OF APPLICANT DATE <br />R <br />Electronic Information: <br />❑ List ❑ Map —Description: <br />KUM <br />Street q <br />FILE ADDRESS <br />Street Name <br />EHD USE ONLY <br />City ty <br />Q Unit 1 <br />N ;© <br />S,tJ D <br />-Uyjt2 <br />2. <br />3. <br />�A'y/%p��%p'�%i <br />f r Me7 IUD <br />;4. <br />r 1 <br />W, 17r <br />/nit3 <br />a <br />/"/ /�/� <br />5. <br />581 <br />F <br />MA/i �Ovr1 <br />r fl UA (t 3 IDry <br />1 r Ami 17ero r <br />G]'Unit4 <br />s. ;- 4 561 <br />F- <br />7. <br />8. <br />_ <br />To view the HMMP (Hazardous <br />Materials Management Plan) go to the <br />following website: www.sjoesdata.org <br />❑ Unit s <br />❑ units <br />9. <br />10. <br />Specific Date Range of Information Requested: From <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON -LOP) <br />UNDERGROUND TANK (MONITORW GIREMOVAL)L'/— <br />}IAZARDOUS WASTE GENERATOR,;; . <br />TIERED PERMITTED FACILITY a, ' <br />TATTOO/BODY PIERCING <br />MEDICAL WASTE FACILITY <br />HOUSING ABATEMENT <br />FOOD FACILITY <br />DOG KENNEL <br />CHICKEN RANCH <br />MDTELMoTEL <br />POOLISPA <br />COMPLAINT RECORDS <br />ENT FILES <br />SOLID WASTE FACILITYNEHICLE[ WASTE TIRE y;6 hieS <br />DAIRY121C./Ij�it�Ll{ Z <br />WASTEWATER TREATMENT PLANT. <br />PUMPERTRUCKIYARDICHEMICAL ToiLETS <br />LAND USE APPLICATION SITES <br />OTHER (PLEASE SPECIFY) <br />WELLAND 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 files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (2091464-0138 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 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 expense of the applicant <br />Future file reviews by the same applicant may require a $125 deposit prior to review - <br />in L•Gta�/ i ,_. /.J s . .I f it `itrS i' / / i i� .!/ i /1 I i 14W <br />KUM <br />Received Time Nov. 27. 2012 12:30PM No.17031(7(112%�Nr� �'f/I a%Dr0&5i�4Rmo�alv,r, <br />107 <br />r <br />