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t <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> NVtROAIMENTAL HEALTH DEPARTMENT -�) <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:wWWAgov.Org/ehd <br /> 74 <br /> ElBZ 6 ti N1 <br /> =3 a`� ^ "i PUBLIC RECORDS RELEASE APPLICATION _ /� <br /> APPLICANT: f1 -G} n j YYIC?•rt SU�S,IMESSfAGENCY:— C_'(0 ice `-3 <br /> ADDRESS: "",C)TYISTATEfLIP: L�.�y.J� C_Ice <br /> PHONE(1); PHONE(21: FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Plsaso allow 10 bualmas days fm dale of application auhmmal•`Tantative only-must be confirmed) <br /> Q CHECK SOX TO E7iPEDIYE REQUEST-5125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN`BUS^ /INESS D. Y3`� 0�/_1���3 <br /> 61GRATURE OF APPLICANT DATE lX <br /> Eleetroni�irTftwmatfon: (�Lfstl]Mep—Deaertpdan: <br /> FILE ADDRESS _ _ EHD USE ONLY <br /> Street■ . . Street Hartle —__ - City <br /> z. I�� � _L_. cis. t ✓� a(1. <br /> ,� ........ .-_. ---- <br /> 3. <br /> 4. <br /> 5 ( f C) r1 <br /> 7. <br /> 8. 17000VC - t, lit . . .. . __. .1}Umt4 <br /> s. 7Do� ✓Y4EUifzf �' l�lG ;. <br /> ❑finite <br /> io. Of? ;bNLj lL' r,')I-"fit i (J. r r!r am <br /> SpedOC Date Range of Information equeste <br /> From --- <br /> EN T_' <br /> YIRONMENTALHEALT EPA NT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUPSITE(LOP( L3 MEDICAL W Q SOUP/WASTE FACRI7YNERICLE <br /> HOTHER CLEANUP Sffz(NoN-LOP) E'HousINGABATemENT ❑WA$TETIRE <br /> UNDERGROUND TANK(MOND PiNGIREMCVAL) LI FOOD FACILITY ❑DAIRY <br /> ❑ASOVEGROUNDTANK O CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> Q HAZARDOUS WASTEIHAZARDOUS MATERIALS []MOWUHUTEL ❑PUMPER TRUCKIYARDICNEMICALT01LETS <br /> HTI'EREO PFRMrMO FAMUTY 0 POOUSPA ❑LAND USE APPLICATION SITES <br /> TAIT00IBODY PIERCING 0 CONPLAINTIRESPONSERMORDS []OTHER(PLEA$E SPECIFY( <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAIu-ABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to tan addresses in the space above. Select the type($)of fites from the list above by checking the appropriate <br /> box(os). At least one file type MUST be selected. Fax to(2091464-0138 or mart to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications roceived after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify tate,applicant if any EHD files exist- An appointment for review will be confirmed approximately ten(TD( <br /> days after receipt of application. The flies wlil be held for a maximum of five business days for review. Appolnimonts <br /> should be scheduled accordingly. <br /> 3. A fNe that Is actively being worked on by END staff may not be imrnediately 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 app icant. <br /> Future file reviews by the same applicant.may r quire a$125 deposit prior to review fi =AdtEA.EFj19CfSE:DIdLI' <br /> �rir .Yl�, ��� 5 t sr.�f'nhF`.f r' �� �L �' i�< fi` w:} %:ni't r,:+••'i't :,'1 `'ha <br /> •1f f".dY+.kr Ir,'iiQ"s'::{ 5# "2, IV .yE, ^9 <br /> f priiVled FAys6ff PF?t .' tti tle#e start t9anw. <br /> 1 <br /> era 6940 m tx <br /> Received Time Mar. 29. 2013 7: 18AM No. 2706 <br />