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01122/2015 16:07 P.0011001 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> RECEIVED ENVIRONMENTAL HEALTH DEPARTMENT <br /> g1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 3 ,JAN 2 3 2015elephone: (209)468-3420 Fax: (209)464-0138 Webwwvv.sjgov.org/and <br /> a <br /> ENVIRONMENTAL HEALTH <br /> PERMIT(SF_RVICES PUBLIC RECORDS RELEASE APPLICATION <br /> 3 <br /> APPLICANT: Robe •r•a Akita) - BUSINESSIAGENCY:AdVanCBdG9DFnVITOnment8I <br /> j ADDRESS: 837 Shaw Road CITYISTATEIZIP:Stockton 1 CA 195216 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> i (Pleaso allow 10 business days from date of appllmUon submittal-`Tonfmlvo only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE RED $125 FEE( 2CK•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _ DATE_f��-, __ <br /> Electronic Information: ❑List❑ Map-Deserlptl4: <br /> FILE ADDRESS Etm USE ONLY <br /> jjyy,,// Slrtet# Street Name City Urw <br /> 1• treet Mw ,�4 <br /> 2• 19 Min r Av <br /> �V 2 <br /> 3. 2150 East Fremont Street Stockton 1mP M U5 <br /> fl-41r, <br /> 4- 103 North E Street Stockton <br /> 5. 36 D Street Stockton <br /> e• 124 North E Street Stockton p" Iwo <br /> 7• 11 South A Street Stockton u� Ll,Nv <br /> e. 1750 East Channel Street Stockton r0 units <br /> 9. LD <br /> 10. 0 Unit 6 <br /> Specific Data Range of information Requested: From all ,I <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SHE(LOP) ❑HOUSING APATEMENT x❑SOLIDWASTE F EWCLP <br /> ❑x OTtERCLEANUPSire(NON•LOP) Ej FOOD FACILITY ❑x WASTETIRE ri 16t; e5, I ce') �t <br /> UNDERGROUND TANK(MONROWKVREMOVAL,-, [I DOG KENNEL ❑X DAIRY t4n,1 :3 P'?�2-I 'JS <br /> x❑HAZARDOUS WASTEGENERATOR,F', ❑CHICKEN RANCH ❑WASTEWATER TREATWNTPLANT <br /> Q TIERED PERIA(TTEDFACIUTY -<.. ❑MOTELIHOTEL ❑PUWERTRUCKIYARDICWXrAL TOILETS <br /> ❑TATTOOIBOOY PIERCING L]PouuspA (]LAND USE APPLICATION SITES <br /> ❑ MFDICAI.WASTE FACILITY Q COWLAINT RECORDS ❑OTHER(PLEASE SPE-CIM <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONnAY-FRIDAYS:OOAM-B:OOPM(EXCLUD(Na HOLIDAYS) <br /> 1. List up to ton addresses In the apace above. Select the type(e)of flies from the list above by checking the appropriate <br /> box(as). At least one file type MUST be selected. Fax to(299)464-OIN or mall to the address indicated above Address <br /> ranges will not be accepted-for additional asalatanea 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 flve 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 flle not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews b the same applicant may require a$125 deposit prior to review. , . T <br /> Y PP Y req 5' Pr C ';tor,: ' <br /> L <br /> :r 0 .r I(o ( 0034 o <br /> 4-1 <br /> ` y <br /> TAv <br /> lefpr 9 4' PrcJ dp4 fotl0a,.,t QtS n fjg50,N � <br /> g Received Time; Jan. 22. 2015 3.59PM No, 7940151) sr �+(u ?, 1 6 k;j,�05T), 300Wz""J' IZ'I 6 (Us)1 <br />