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■K 0411012015 13:1.5 (FAX) P.0011001 <br /> ■ <br /> ■� EHD LOG NUMGjR <br /> �■ iA]E SAN .lOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> APR 10 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax, (209)464-0138 Web: WWW.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: William Little- BUSINESS/AGENCY: Ad van . _dG _o nvironm _ata) <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton / CA / 95216 <br /> PHONE(1): 209467-1006 PHONE(2): 209- FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> SO (Please allow 10 buslnass days from date of appllcatlon submittal-'ren(aUve only-must be confirmed) <br /> Q CHECK BOX TO EXPEDITE REQUEST-$12 F E(CASH OKM <br /> Y)-REQUEST PROCESSED IN 3 OUSI//N/ESS DAYS <br /> SIGNATURE OF APPLICANT Vll I � 1 � X DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY % <br /> Street# Strset Name city Unit 1 <br /> East Louise Ave Lath <br /> Unit400 D'Arcy Parkway LathrQp <br /> 2 <br /> ' -0"/Unit 3 <br /> 6. Unit 4 <br /> 7. <br /> $, /7 Unit 6 <br /> 15 <br /> 10. 1 `�` ❑Unit-L] <br /> Specific Date Ranee of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> xl1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT M SOLID WASTE FACILVNEHtCLE <br /> x1 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY M WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL 0 DAIRY <br /> Q HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> x❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOL/SPA O LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> 1. List ua to ten addresses In the apace above. Select the type(s)of files from the list above by checking the appropriate <br /> box(ea). At least one file type MUST be selected. Fax to(20$)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHp. 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 /> daye after receipt of application. The flies will be held for a maximum of five 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 now 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 applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> EHO USE ONLY <br /> j <br /> Pwnas is CNH1 <br /> Received Time Apr. 10, 2015 1 : 12PM No, 8510 <br />