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o❑ 0112212015 16:07 (FAX) P.0011001 <br /> 1�3 <br /> I ❑ <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ❑ �, ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 C I <br /> JAN 2 3 ZOMlelephone., (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: RebeCCa Natal BUSINESS/AGENCY: aI <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton /CA/ 95215 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-"Tentmlvo only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE RE $ ( -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT VWAI DATE. <br /> Electronic Information: [3 List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city -U It 1 <br /> 1. 1947 East Channel Street Stockton <br /> 2• 1950 Miner Avenue 'i nit2 <br /> 3- 2150 East Fremont Street Stockton -loos <br /> 4. 103 North E Street Stockton -911:3 <br /> 5. 36 D Street Stockton <br /> 6- 124 North E Street Stockton El Unit <br /> 7. 11 South A Street Stockton <br /> e. 1750 East Channel Street Stockton Q Unit <br /> 10. .-ti'nit s <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP$ITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FACIUTYNEHICI.E <br /> x❑OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑x WASTE TIRE <br /> Q UNDERGROUND TANK(MONRORftREMONAL) []D00 KENNEL ❑x DAIRY <br /> x❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERNMED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCK/YARDTHEMICAL TOILETS <br /> ❑TATIOOIBODY PIERCING ❑POOUSPA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS Q OTHER(PLEASE SPECIN <br /> WELLAND 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(2Q9)4ti4-0'1 -or mall to the addr055 Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD villi 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 EHD 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 some applicant may require a$126 deposit prior to review. <br /> J ����) ( til ��' �:•�: .i�. �.�l�-'li I�i(...�..�L',l` '� ,�.'".. 1rI" LL' L'F.'� 1't. �1Z.J I <br /> 1 -09 V <br /> A/1111 <br /> Received Time Jan. 22, 2015 3:59PM No. 7944 <br />