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'rom:Marcus bole & Associates §� �i 11 /17/2013 18:21 #014 P.001 <br /> A C EHD LOG NUMBE <br /> � GAVG® SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Nov 18 21113 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENUIRONMENTALHEALTH <br /> PERMITP,- CES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: )),+yl !� ENTALI►�LJII <br /> �l I% BUSINESS/AGENCY: b�GL:Rjyj <br /> ADDRESS: ID `I gle.ac4 QIZ CITY/STATE0P: k17/pifrl,f,Vbf cit- 95 6�j <br /> PHONE (1): I /�3p-�//�-(�(o 3 PHONE(2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: )I -dl Time: <br /> (Please allow 10 business days from date of appllcIL submittal 71Tentadve only-must.be confirmed) <br /> CHECK BOX TO EXPEDITE REQUESY-$125 FCHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ///��/ /J DATE l) /J <br /> Electronic Information: ❑ List❑ INap-Description: <br /> FILE ADDRESS EHD USE 0 D <br /> Street# Street Name city �� <br /> P Unit 1 <br /> E e � Sr^�a N Tea) ml <br /> t IY� <br /> 2. S 3 q2 Sr <br /> 17)� ❑Unit z {1 <br /> 3• s, til LSun/ Ck- /✓ y � p5 1 �1t <br /> 4. pD E MA-JAI sr PCk FdA/ z ! IJ Unita (� <br /> 5 0 <br /> 6. <br /> 7. <br /> Unit d <br /> 9 r .} <br /> Units <br /> 10. l� I ; T D 9 5 f unit 6 <br /> Specific Date Range of Information Requested: From fy I(7Z'1/V' to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> M-NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILnY/VEHICLFj <br /> HER CLEANUP SITE(NON-LOP) <br /> El ABATEMENT WASTE TIRE , rj <br /> U DERGROUND TANK(MONITORINGIREMOVALV\ ❑FOOD FACILITY ❑DAIRY 1�-^i`1�" <br /> ABOVEGROUND TANK d� - ❑CHICKEN RANCH/DOG KENNEL <br /> y��}�j�^ZARDOUS WASTEIHAZARDOUS MATERIALS ❑WASTEWATER TREATMENT PLANT <br /> .t.2 IERED PERMUTED IHAZARDOUAclLrrY V4- ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICACtOILETS <br /> ❑POOLISPA ❑LAND USE APPUCATION SITES <br /> ❑TATTOOIBODY PIERCING 0�50MPLAINTIRESPONSE 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 files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 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 theappllcant 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 thea icant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> .3^l �'`•., r '. y',t rr a�,� 'h w Y Kos L;1.'F r i y # t¢ ^y�`x 'i` <br /> r t <br /> EHD 46-06 <br /> B/N12 <br /> Received Time Nov, 17. 2013 5: 19PM No. 4549 <br />