Laserfiche WebLink
AUG-14-2014 THU 09:23 AM N, s Twining Associates FAX N0, 268 7126 P. 02 <br /> DATE R `� r3 EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> Q�C� ENVIRONMENTAL HEALTH DEPARTMENT 5qo <br /> 03�-t 1 . 1868 East Hazelton Avenue, Stockton, CA 95205-6232 qs <br /> Teles p,r -;A209) 468-3420 Fax: (209)464-0138 Web: wwvv.sjgov.org/ehd <br /> vj�� <br /> �l RNWOS� FYJBLIC RECORDS RELEASE APPLICATION <br /> 'APPLICANT: Ell? M—, 6t-ve--c- BUSINESSIAGENCY: rng7t-e <br /> ADDRESS: 2,5 2"7 Fie sno CITY/STATE/ZIP: es..v cA 9.3 <br /> PHONE(1): (5�5-Y) 2 6 - 702-1 PHONE(2): (5-SA) -778--ISq t FACSIMILE: &S-1) Z6"0- 71 26 <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-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �� /�'� -" DATE 6//3//�/ <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City 0 Unit 1 <br /> 2. Gj. Fie v-.0 n 3 S 4-r ee -4 IO[� �o v Unit 2 <br /> r Iktl� <br /> 3. 2 q g L.� F«r- s�, Q r S �rn•-, .NO 2�2;&J <br /> 4, 1,qo.� L,1 . re. r 4- S I reQ+ 5�o�Gcd� tnit 3 1 <br /> r // ��it <br /> 5. `�f2 2 3> om. ��.l:�o� �ihrc��P� S�OC�-L" 4 <br /> Q 75 <br /> 75 <br /> 8` 19 l �S) `� `,a ` U ❑Unit 5 <br /> 9. <br /> J2 C1 <br /> 10. I 24,It s <br /> Specific Date Range of Information Requested: From to <br /> �--,� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �LM U DERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY �SOLIO WASTE FACT41TYNiHIOL)i� � <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT WASTE TIRE 7{11351C(�$(�J�Z_I� � <br /> [UNDERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑pAIRY l l M-11 <br /> 20OVEGROUNDTANK ❑CHICKEN RANCH/DOG KENNEL WASTEWATERTREATMENT PLANT �' o <br /> �HAZARDOUSWASTEIHAZARDOUSMATERIALS p/� F-1MOTELIHOTEL E]PUMPER TRUCKIYARDICHEMICALTOILETS C <br /> [TIERED PERMITTED FACILITYb( ❑POOLISPA BLAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ZCOMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) _o <br /> c• <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) �--. <br /> 1. List un to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate N <br /> box(es). At least one file type MUST be selected. Fax to(208)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. NIZY <br /> 2. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. 8 <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**' LQ <br /> - Zof r,-; <1 /iQP Av dtlj G 0 1 PIAJ 410 Ll 6,U21 L/ g <br /> n <br /> &V77 <br /> 50 D. 1 c t7z 5 a�5 o v' V7 <br /> pr.044clecl-by-64& ff PPR 0+ 41&2S E� <br /> Funda_na (-0 ilG�i — A(nJ �f/ i �i�'(� 0.41 ( k5(O(f <br /> Received Time Aug, 14. 2014 9. 14AM No. 6831 CDooa 'lzG ,s .n ljlyr IL �, NZ0 /Ucic�sQ151g�. <br /> 6000 �Z1-3 n ri 11 W A;1t �pr V-W M44 <br />