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-• ----• ----- ---_.,+..��-+ v�uwv wivau�rwvia rHVC nun� <br /> DATE RECEIVED1� <br /> C� SAN.IOAQUINCOUNTY EHD LOG NUMBER <br /> y C Jt NVIRONMENTAL HEALTH DEPARTMENT <br /> 1868;East Hazelton Avenue, Stockton, CA 95205-6232 A W <br /> /i Telephone: (209) 468-3420 Fax; (209)4640138 Web: www,sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICANT: APPLICATION <br /> !?•e/ J' i'N�i✓i� BUSINESS/AGENCY:—_ C���OCair/ <br /> "� <br /> ADDRESS: �/�G 4!5;t, 4/,7 7r /JiP,-, --� CITY/STATEMP: � n/ D Cp/loo✓� <br /> PHONE(1): 7/���,��/� PHONE(2): ��./rj'// FAG9IM+L-e: .. 17?- <br /> Please <br /> Please allow 10 business days from date of application submittal for the records to be available, <br /> Staff will I contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-s1j2,6,rW.SQ}�SH-OR E,HECK ONLY)-REQUEST PROCESSED IN 9 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List p—Dc riptlon: <br /> FILE ADDRESS ___ EHD USE ONLY <br /> SVso[7! Stmat Name City N ❑Unit t <br /> 2. _AxP-lZ OOQ3 _ <br /> (2 unit 2 <br /> 4• (.7 /I`"' f�CY.�i�' 1 ,1 t '\.rL"J Unit3 <br /> _- J <br /> unita <br /> T. <br /> S. <br /> 0 Unit5 <br /> 9. <br /> 10, Unit G <br /> Specific Datn Range of Informatlan Roquested: From to ____ I `QY <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ONDERGROUNO TANK(UST)CLEAMIP SITE(LOP) E]MEDICAL WASTE FACILITY [_]SOLID WASTE FACILOyfvvicLE jw4 3 <br /> THER CLEANUP SITE(NON-LOP) - ❑HOUSING ABATEMENT ❑WAsm TIRE tAii'Y+').td31 Pall¢ <br /> UNDERGROUND TANK(MONrrorUNGIREMOVAL) ❑1 FOOD FACILITY ❑DAIRY f', trAi ,LLt flys l <br /> ABOVEGROUNDTANK U CHICKENRANCHI DOG KENNEL ElWASTEvvATERTREATMENTPLANT , 1-21 5 <br /> 9.1 <br /> AZARDOUS WASTEIHAZARDOUS MATERIALS [j MoTFLIHO75L ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> rLj IEREb PERMirTED FACILITY ❑POOLISPA ❑LAND UsE APPLICATION sirts <br /> ❑'`T,.ATTTTO�OIa-ODYPIERCING ---� ❑COMPLAINTIRESPONSE RECORDS L]OTHER(PLEASE SPECIFY) <br /> wvaLL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 13:00 AM-5;00pM(EXCLUDING HOLIDAYS) <br /> 1, List up to ten addressCS In the space above. SP.lect th tr/pc(s)vi-flJ3s-from the Ilstabove by chocking the appropriate - <br /> beX(es). At least one file typo MUST be selected. to(2091464.0138 r malt to thea dyes indicated above. Address <br /> ranges will not be accepted,Applications received affArm 0_13111wMJLbe-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 EHD will notify the applicant If any EHD foes 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 /> 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 AREA-EHD USE ONLY*** <br /> vw\tl ait.'wcl�_�,-•net 3• G1get.±��e� f J>,(Z__e i' � '�. 5`1..1"tt?��� <br /> JAoV 7. t- c`� [r.Etc� fir 355 49• unl <br /> G. Sec/?t I e+-ter� Trtvd t 1 M <br /> 11C&rt51o6 for C00006Mb-1 <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> nen an.x aznna <br /> Received Time Jan. 7. 2015 2:43PM No- 7851 <br />