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x Fage 4 of4 <br /> EHD LOG NUNISER <br /> k EI .<_ SAN JOAQUIN COUNTY � <br /> �� ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUL 21- 201�ti 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ltone: (209) 468-3420 Fax: (209) 464-0138 Web: WnVW.Sjgov.orglehd <br /> ���Lr,,i I,-ISS E100 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Erlcasurkert BUSINESS/AGENCY; Ecolala <br /> ADDRESS: 1601 West DieWRoad CITYIST•ATEIZIP. Na ervitle.IL60S63 <br /> PHONE (1): 636-305-2117 PHONE (2): FACSIMILE: SOD-7-24-9176 <br /> Please allow 10 business days from date of application submittal for the retards 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-$13D FEE(CASH OR CHECK ONLY)-REQUEST PP,OCESSEC)fN 3 BUSINESS PAYS <br /> S€GNATURE OF APPLICANT ���� _ DATE 07/26/2016 <br /> Electronic information: ❑ List ❑ Nrlap— Description: <br /> FILE ADDRESS EHD USE ONLY <br /> - Street# Street Name City <br /> 1537 -I Lower Sacramento Road Lodi <br /> 2. 6530 Pacific AVeRUE Stockton W _ 11" [aJ [�Unit 1 �t <br /> 3. Unit 2 <br /> T i] Unit 2H <br /> 5. <br /> 5. I Unit 3 <br /> ], ❑Unit 4 <br /> g, SITE MITIGATION <br /> A <br /> 10, ❑ unit 5 <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDEP.GP.OUND TANK(UST)CLEANUP S€TE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID NdASTE FACILITYIIIEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑AIASTE TIRE <br /> ❑UNDERGROUND TANK(RAO NITORINr.IREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑VVASTEWATERTREATi4ENT PLANT <br /> ❑HAZARDOUS VI,fASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKNARDIGHEPAICAL TOILETS <br /> ❑TIERED PEIRMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTDOBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FR€DAY-8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List un to tent 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 (249)464-0133 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$130 deposit prior to review. r 136XED AREA-EHD USE:ONLYY <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48•ns mrt s <br /> Received Tirrie Jul. 20. 2016 7 : 33AM klo, 1021 <br />