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�y L AT EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY- <br /> AUG 2 �� ENVIRONMENTAL HEALTH Dtt-939 <br /> Y <br /> 1868 East Hazelton Avenue Stocktolt <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.o <br /> ENVIRONMENTAL HEALTH <br /> PEFtMItTISER°11GES PUBLIC RECORDS RELEASE APPLICATIOW ' " <br /> APPLICANT: Michael J.O'Leary BUSINESS/AGENCY:MJO Earthscience Services Inc. <br /> ADDRESS: PO Box 624 CITY/STATE/ZIP: Los Gatos,CA 95031-0624 <br /> PHONE(1): (831)688-1007 PHONE(2): FACSIMILE: (831)688-1079 <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-$125 FEE( A H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 8-21-2014 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. 1627 Army Court Stockton _( <br /> 2. ❑Unit2 <br /> 3. J f <br /> 4. <br /> Unit 3 <br /> 5. <br /> 6. <br /> Unit 4 <br /> 7. <br /> 8. <br /> ❑Unit 5 <br /> 9. <br /> 10. ID <br /> Unit 6 <br /> Specific Date Range of Information Requested: From 1985 to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY [:]SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TIERED PERNiiTTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> Q TATTOO/BODY PIERCING X❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(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.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 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 /> 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. ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 46.06 <br /> 4128/14 <br />