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DATE RECEIVED, - EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> JUfV .E ' 2015 ENVIRONMENTAL HEALTH DEPARTMENT 'S <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-8232 � 1 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org)lehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebekah A.Wilson BUSINESS/AGENCY: TrileafCorporatioh <br /> ADDRESS: 2121 West Chandler Boulevard, Suite 203 CITY/STATE/21P: Chandler,Arizona 85224 <br /> PHONE (1): 480-850-0575 PHONE(2): 480-244-2543(cell) FACSIMILE: 480-850-0578 <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 REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANfo���f , DATE 6l/-7y/S <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Streeter Street Name City <br /> 1. 150 North Sinclair Avenue Stockton - <br /> 2. _ I i I;(es rites <br /> 171 Unit 2 <br /> 4. Vt <br /> ^. .❑ Unit3 -^ <br /> - SITE MITIGATION <br /> - / ❑Unit 4 <br /> 7. <br /> r, ❑Unit5 <br /> 9. <br /> 10. <br /> ❑ Unit 6 <br /> Specifl;Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ®SOLID WASTE FACILrrYNEHICLE <br /> ©OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT X❑WASTETIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ®DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> M HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTEUHOTEL ❑PUMPERTRUCKIVARDICHEMICALTOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ®COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY B:OD AM-S:OOPM(EXCLUDING HOLIDAY$) <br /> 1. List up to ten adIrespeg. 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(209)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be 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 files exist. An appo?ntment 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 roorganlzed by EHD staff at the expense of the applicant <br /> Future file reviews by the some applicant may require a 5125 deposit prior to review. * BOXED AREA-EHD USE ONLY' <br /> 11 1 <br /> ❑ Records provided by Staff-PPR Complete, staff Name: <br /> Eno 46-06 <br /> ....... _. snots <br /> Received Time Jun, 11. 2015 9: 39AM No. 9002 � <br />