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`NOct 13 2014 9: 5GAM Baso ^s Environmental , Inc 5100-449088 P. 1 <br /> ■ <br /> IN <br /> IN <br /> O � <br /> DATE RECEIVE!,r--1v E <br /> SAN JOAOUIN COUNTY EHD LOG NUMBER <br /> OCT --0 20j4 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205.6232 <br /> ewt'�i�lt;���•,,F��-fr,Tel_��iione: (209) 468-3420 Fax: (208) 484-0138 Web: www.sJgov,orglehd <br /> PUBLIC RECORDS RELEASE APPLICATION ' <br /> APPLICANT: APS prJ C—q DUSINESS/AGENCY: ?pP SILS G1-jJ• 1►U L . <br /> ADDRESS: 6 2.7`� STI_EfJI', Su ,re ( 1 6 CITY/STAT&ZIP: O rJr) L p <br /> PHONE (1): (Clogy 8 34 — q 01q IN PHONE (2): (�L2� 2D°(^�1a�,1 FACSIMILE: Cstb g�W rgng8 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE $130 F (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTREQU - DATE I d 1 )}l 14 <br /> Electronic Informatlon: ❑List❑ Map—Description: <br /> FILE ADDRES13 EHD USE ONLY <br /> Street Street Name City "I Unlit 1 <br /> TN U. S7—r.EE 1 '(-" PJ �, �' <br /> � e - Unrt 2 <br /> 3• X11 car ,� n�M vv v.�tt0 , )VI <br /> 4. <br /> `> �� :2 Z - 'c � ''% 'u Units ; <br /> 6. <br /> 6. <br /> Untt 4 <br /> i. <br /> 8' <br /> Untt 6 <br /> I El v, <br /> 10. unit e <br /> Specific We Range of Information Flequeeted. From to / <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) EDICAL WASTE FACILITY LID WA6TE FACILITYIVEHICLE <br /> HER CLEANUP SITE(NON-LOP) OUSINO AEIATEMENT 0ASTE TIRE ' <br /> �l�'S kv <br /> ?N09ROROUND <br /> TANK(MONITORINGIRf?MOVALk_. fF000 FACILITY IRY <br /> OVEGROUND TANK L- ❑CHICKEN RANCH/DOC KENNEL �ASTEWATER TREATMEkrr LANT <br /> WASTEIHAZARDOUS MATERIALS,;' ❑MOTELIHOTEL IJ PUMPER TRUCKIYARDICMEMICAL TOILETS <br /> r <br /> ICRFD PFRMRTGD FACILITY ,J ❑ OOLISPA 2rLAND/IBE APPLICATION SITES <br /> ATTOOIBODYPIERCING QCoMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WMLL AND SEPTIC PERMIT RECO1qD8 AR!'AVAILABLE FOR Review: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDIN13 HOLIDAYS) <br /> 1. List ua to tonsddrrssss In the space above. Select the type(e)of Alae from the flet above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)484-0139 or mall to the taddrevs Indicated ab. a. Addreas <br /> rengee will not be accepted.Applications received atter 3:00 pm will be processed the next business dsy. <br /> 2. For aaelstence In Identifying the nature and content of EHD rsoords, please contaot EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD files exist. An appointment for review will be oonflrmed approximately ten(10) <br /> days after receipt of application. The f11aa will behold for o maximum of five buslne"days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned In the same condition as releaead will be reorganized by EHD staff at the expense of the applicant. <br /> Future file ravlaws bythe some applicant may require a$130 depoeit prior to review, ""BOXED AREA-EHD USI ONLY`"' <br /> ❑ Records provided by Stet(-PPR Complete. Staff Name: <br /> 1HD 48-Oe tn4 <br /> Received Time Oct, 13, 2014 9 :54AM No. 7314 <br />