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Z� <br /> EHD LOG NUMBER <br /> *SAN JOAQUIN COUNTY <br /> � s ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> JUN 4. �gpiephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> EfSp,cQ1,I(9 R1T,4LHEALr , PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ('email Vihl� BUSINESS/AGENCY: (?Cal °�L1 Inc. <br /> ADDRESS: S 7 CI) S�eOfii -Sti%k CITY/STATE/ZIP: �we;l(A} Cf , I TOT <br /> PHONE(1): *7a ,, I1 YE.S If I PHONE(2): yIS.Sly - 7'ePp FACSIMILE: `dI S9 LFapl D <br /> TENTATIVE*APPOINTMENT DATE: 6ta A l fcaS-r Time: <br /> (Pleaee allow 10 buelnasa days from data of application submittal-'Tentative only-must bo confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQ ST- 125 FEE,(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 SBU INESS DAYS <br /> SIGNATURE OF APPLICANT !AAS 4 Dyer!/ DATE <br /> Electronic Information: ❑ List ❑Map—Dascription: <br /> FILE ADDRESS EHD USE-ONLY / <br /> i P <br /> Sfroet M Strcot Name CLIry. / kr") n <br /> M <br /> i. '7- F-4 �% v N'l. 5'� 7af. T �J"t f7Z I , I. 'I�I <br /> 1 .Y 2. 7trp r' PV\ �O U It 2 G <br /> 4. '316 ri1 ;16v1 �k �Y 3 / �p unn 3 I/ <br /> 5. l�6. , IUnitn <br /> 7. d <br /> 8. ❑Unit s <br /> 9. <br /> 10, _,Q nit 6 <br /> Speclac Date Range of Infonoatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUPSITE(LOP) ❑MEDICAL.WASTE FACILITY ERISOLID WASTE FACILITYNEHIC}� f� , <br /> ER CLEANUPSrrE(NON•LOP) ❑HOUSING ABATEMENT QWAS TE TIRE �'('P rj rN✓ y ' <br /> DERGROUND TANK(MONITORINGIREMOVAL],/" ,❑FOOD FACILITY []DAIRY <br /> ) J f7-ip -13 <br /> FRED <br /> OYEGROUND TANK sX ❑CHICKEN RANCH/DOG KENNEL r9 ASTEWATER TREATMENT PLANT <br /> ZARDOUS WASTENAZARDOUS MATERIALS:j— ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS_ <br /> PERMITTED FACILITY N_ �❑yP'OOLISPA ❑LAND USE APPLICATION SITES <br /> E]TATTOOIBODY PIERCING QCOMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMrr RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br /> 1- List ua 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 mall 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 file's exist. An appointment for review will be confirmed approximately ten(1 D) <br /> days after recelpt of application. The flies will be hold 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, BoxeD�aneA- No use o r <br /> a � <br /> a .. .Y . r <br /> _ <br /> =rc- t�6T.� i.'v�f7e iP G.'�-'ariB . <br /> Received Time—J n. 4 —20 ID 3. 11PND. 72 ' 01 f4&W r"10(9 ,5,A 5V Flu <br /> 10 1/4 `♦' 9�i 5t8� t5robagA00bI�z) ;5.;n�+1�"le Z—f N,-,l66 <br />