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i■■Dec 02 2014 5: 19PM Bas-ics Environmental , Inc 51 349098 P . 1 <br /> ■ <br /> EHD LOG NUMBER <br /> OTE RECEIVED -�- <br /> �: +�i�� v�� SAN'.IOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> DEC 02, 20.11' 600 East Main St. Stockton, CA 95202-3029 5 <br /> Telephone: (208) 468-3420 Fac: (206) 484-0138 Web: www.sjgov.org/ehd <br /> -NVIRONMENTAL HSEA TH <br /> FEi�P1.ITlS4=i=t?l;r;�S <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: GbwWtr�4 `?'r�M BUSINESSIAGENCY; g 7(x,5 rY1�W -T►�-L. <br /> ADDRESS: .4� ST, 4-11-6 CITYISTATE/ZIP: V bOeA-*,- V Lary-- - <br /> PHONE (1): t5�1a e,3 '� e1 01 PHONE (2): FACSIMILE: P,5'T. 9,3� l b 1 <br /> TENTATIVE"APPOINTMENT DATE:_ ) '2^1 fir') Time. r"c) mac <br /> (Plates allow 10 business de s from dots of application submittal•-Tsntatlys only -must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITERE E FEE(CASH OR CHECK ONLY)- RE-QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I <br /> Electronlc information: List ❑ -Descriptlon: <br /> FIDE ADDRESS EHD LISP 0KILY, f} <br /> Street# 'treat Name CRY Unit 1 <br /> 2. I i2 ��unit2 <br /> 4„ h ' �II� Unit 3 <br /> 6• . /LEJ unit <br /> 7. <br /> 8. 0 Unit 5 <br /> 9. <br /> ,10. U,unit 9 <br /> ffipacillc Date Rang*of Information Raquestod: From to <br /> ENVIRONMENTAL HEALTH DEPARTMICW FILES <br /> 1N RGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEAt'ENTS ID WASTE FACILITYNEHICLE <br /> ERCLFANUP SITE NON-LOP FOOD FACILITY ASTE TIRE <br /> N ROROUND TANK(MONITORiNGIREMOYAL) DOG KENNEL ❑DPY <br /> OU S WASTE GENERATOR CHICKEN RANCH E3WASTEWATERTREA7MENT PLANT <br /> FTATTOUB <br /> ED PERMITTED FACCITY MOTELMOTEL ®PUMPER TRUCKIYARC/CHEMICAL TOILETS <br /> ODY PIERCING ��PLISPA LAND USE APPLICATION SITES <br /> ❑`MEDICAL WADTE FACILITY 2 LOMPLAINT RECORD OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC Partiyi i RECORDS ARrAVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:0OPMV EXCLUDING HOLIDAYS) <br /> 1: Wei uo to ten addr+esaag In the space above. Select the type(s) of files from the list abwm by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fdx to(ZQ9)444-8139 Qr mall the adclreaa ItldlcatQd move. Address <br /> ranges will not be accepted •for additional assistance with file addresses, contact the EHD. Applications received aftar <br /> 3:00 prn will be processed the next buslneaa day. <br /> 2` The EHD will notify the applicant If any END Flies exist An appointment for review will be conflrmed approximately ton (10) <br /> days after receipt of application. The files will be held for a maximum of five buslnesa days for review. Appointments <br /> should be scheduled accordingly, <br /> 9,.:.A file that is actively being worked on by EHD staff may not be Immediately avallable for review. A now application may be <br /> submitted when the fl Is Is available. <br /> ."Any file not ratunned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> future Ilia reviews by filo some applicant may require a$125 deposit prior to review. <br /> EHD UE:E ONLY <br /> "Received Ti:••e_Dec, 2_2014— 4: 16PM--No. 7644 Willi <br /> tn4.40oe -_ <br />