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t 9[01 'S[ '[np awl PaAl �0;� <br /> `HVED LL60 'ON M EHD LOG NUM13 I Ek <br /> DATRE-n-I)r;W� <br /> 1 <br /> SAN JOAQUIN COUNTY <br /> JUL mrs ENvIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue,Stockton, CA 95205-6232 <br /> 9NVIHQ.NMENTAL KqTj.� Talaphans: (209)468-3420 Fax:(209)464-0138 Web;wwwzj�ov.c.9/ehd <br /> PERMI I k3E RVI C ES PUBLIC RECORDS RELEPASE APPLtCAT�014 <br /> i <br /> APPLICANT <br /> IK5:DRESS: ATEIZIP:_ <br /> _91-40 HM 51 SU,+P,5 CITY/ST <br /> PRONE(I)- PHONE(2): FAX OR E-MAIL: <br /> Please allow 10 business days from date of application submittal for the revcc°ds to be v iIsb <br /> le. <br /> Staff d ill contact you to arrange an appointment date and time to reviewthe 'equested records. <br /> CHECK UOX -0 EXPEDITE PEOLIEST 13 FE (CASH OR CHECK ONLY)-REQUEST PRO'ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE DATE ]jjefllio <br /> OF APPLI �-ANT �Vab <br /> 11', LIRI up to len Pd-d,r !2ses In the low. selocY lt <br /> he of files from the list belcA by checking the appropriate <br /> box(es). At least c ie file type MU ST be selected. 2the;L,8 rp!Es Indicated above. Address <br /> ranges will not be iccepted.Applications received after 3:00 pm will be processed the Ile dt business day. <br /> 2.: For assistance In I lentifying the nature and content of EHD records,please contact EHI) it the number noted above. <br /> r ravlew%,011 lac confirmed approx�mately ten M) <br /> The EHDwM notlt- the appticnnt if any EHID flies exist. An appointment fo <br /> days after racalpt,-f application. The flies will be hold for a maximum of fire business t la fs for reylew. Appointments <br /> should be schedul td accordingly. <br /> 4. Any file not d Iff the same condition as released will be roorganizad by EHD stats*e-L the expense of the applicant. <br /> ': , <br /> Future file ruvlme- by the same applicant may require a$130 deposit prior to mylow. <br /> iNELL AND SEPTIC F EP�111T RCCOPDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00A9il-5:00PM(EXXCLUDNG HOL-[DAYS) <br /> _ecCronlc Informat on: [] List [] Map—Description: <br /> E I <br /> Specific Date Ran, e of Information Requegtad: From <br /> I FNVIPEN—MENTAI <br /> 11,1112ALTH DEPARTME NT FILE ADDRESS 'EN'D USE CANL" <br /> FILES <br /> UNDERGROUND TANK JUST) StFoat 9 Street Name C ltY .1 — <br /> CLEANUP SITE(LOP) <br /> 1F!rR ekum 1�1'Qo; <br /> HAZARDOUS WASTE <br /> hi TIMED PERMITTED FACILITY <br /> MovrGpouNo TANK PWS <br /> V-1 UST (MONITORING I REMO% -0 <br /> WzAnoous MATERIALS S <br /> SPILLIRZLEASE RISGPONSIE El WATER QUALITT <br /> SoLlo WASTE FACILITY/VEI CLE <br /> Foob FACILITY pl,tcd h gGvrr.MmcATioN <br /> rj PoQL I SPX <br /> CIj DAIRY <br /> LAN0,UstAPPLjCA:r!0N 91-n H <br /> SEPTIC PumprA TrUCK/ <br /> yrR0 I CHEMICAL TOILFTS <br /> Ej QUPA <br /> WASTEWATER TREATMENT I ANT <br /> HoUsimo ADATEMENT <br /> MOTEL/HOTEL Fcupg­.1j, <br /> CHICKEN RANCH I Doc K0 IEL <br /> MEDICAL WASTE FACILITY <br /> TATT00100DY PIERCING U/SoklP WATM <br /> WAsTE TIRE <br /> I. <br /> COMPLAINT 0 Accouwmr. <br /> C]OTHER(PLIEASE SPECIPY)! <br /> ­SnxGD AREA 12HO USE ONLY'" <br /> oil <br /> r'omplGte. StaffNarns: <br /> 0 Records pro-vi ied by taffv <br /> -PPR <br /> EMD 4S-06 <br /> I f)A I nn * 4 c1 q j—4 LO Z1. <br />