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From:Marcus H. Bole & Associates 530+633+0119 05/18/2012 10:22 #239 P.001 <br />DAT�ra �EHD LOG NUMBER <br />SAN .IOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />all Telephone: <br />East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />�cvv)r�oO,rri„ERvc S,~TN PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: 44. V 1 ®L wf ?— BUSINESSIAGENCY��:”" PQ// 6 t' <br />ADDRESS: 0 C J City/State/Zip .tee <br />PHONE (1); 3 ro PHONE(2); �3�'0LL l /- —fOipa�3 �G� FACSIMILE: <br />TENTATIVE" APPOINTMENT DATE: 7—'?40AV /t✓ Y ft S 1�/YJ��SI��G Time: <br />(Please allow 10 business days from date of application subs "Tentative only • must be confirmed) <br />C CHECK BOX TO EXPEDITE REQ T •/105 FEE CAS OR CHECK ONLY) - REQUEST PROCESSED IN 3 8 SINESS DAYS <br />SIGNATURE OF APPLICANT -�C1sd DATE <br />Electronic Information: ❑ List ❑ Map - Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />Street# �_ <br />Street Name City <br />❑ Uiiit"1 <br />n., h <br />G. <br />_ Unit 3 <br />Lo <br />2. <br />3.71 <br />N <br />4. <br />rRjAL pp <br />5. <br />WwsrkiAL <br />*40 wo <br />r " <br />7._1%L <br />u m 6M1 1 anV7s cYCJ-1, <br />0 :ST—C) <br />(-C ❑ Unit <br />9. <br />I � <br />_._....._e-s''� 171Unit 6 <br />L10_ <br />-- _ <br />Specific Date Range of Information Requested: Fromy �fP�P A'jt to Y <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) C] HOUSING ABATEMENT 1!( SOLID WASTE FACILITYNEHICLE <br />OTHER CLEANUP SITE (NON -LOP) M FOOD FACILITY AWASTE TIRE <br />UNDERGROUND TANK (MONITORING/REMOVAL) 01- 0 DOG KENNEL 0 DAIRY <br />HAZARDOUS WASTE GENERATOR 0<-- E3 CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL 0 PUMPER TRUCK/YARDICHEM TOILETS <br />❑ TATTOO/BODY PIERCING EO POOL/SPA n� ❑o ND USE APPLICATION SITES <br />11 MEDICAL WASTE FACILITY OTHER (PLEASE SPECIFY) � l� 1K-- �/- W", d <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM -5:004 - EXCLUDING HOLIDAYS. <br />1. List up to ten addresses 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 — for additional assistance with file addresses, contact the END. 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 five business days for review. Appointments <br />should be scheduled accordingly. <br />3. A file that is actively being worked on by END staff may not be immediately 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 applicant. <br />Future file reviews by the same applicant may require a $105 deposit prior to review. <br />A/ EHD US�ONLY <br />+16' � —01a <br />/114 <br />EHD 4 -06 8/04/08 ✓2Po vpy tGU/ s �1�CrC <br />�or qwq I00"-, :t�m�� <br />. 0 E <br />Ct7 7 1 %flit "1 I �. / , �iF1iG�t i� .1 t ,r� C16i -�n4 / _ - _ r_' I i i z !tT �'� • �� <br />