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SAN JOAQUINCCZ 50—s'�N WbC�'' l ZIOZ <br /> RECEIVED, �l `ln� au�i� pania�a� <br /> ENV 10NMENTAL HEALTH DEPARTN�T <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-8232 , <br /> ) � Z01Z Telephone. 9)468-3420 Fax: (209 464-0138 Web: .sjgav-org/ehd <br /> fcNViRCNMEN7ALNEALTH 06ff <br /> pERM1TISERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> 4f <br /> APPLICANT: 1J BUSWESSIAGENCY: f [•��J� UL(�[� <br /> ADDRES5: C1TYiSTATE12iP: SAW <br /> PHdN1=(1)= PHONE(2)_ FACSIMILE; <br /> TENTATIVE*APPOINTMENT DATE: Qj r <br /> (Please allow 10 business days from da of application submittal-'7'entadve only-must be CoAfirmed) -- <br /> CHECK BOX TO EXPEDITE RE(!UE -$125 PEE(CASH OR CHECK ONLY)=REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT - DATE__!k/_/14 <br /> Electronic Information: ❑List❑Map»Description: E[. <br /> FILE ADDRESS CHO Us ONLY <br /> Street# -Street Name city <br /> ©Unit 1 <br /> E 71�. c:( <br /> mom.. t3 ; <br /> i Unit 2 <br /> Mllu <br /> unit 3 <br /> 6. La/Units... <br /> 7. 612 W 11 TH ST, TRACY 21 <br /> $' 614 W 11 TH ST, TRACY Ci`4� }? [2 Unit's <br /> 616 W 11TH ST, TRACY <br /> 9. 618 W 11 TH ST, TRACY _ <br /> 10. 620 W 11TH ST, TRACY El Uniks <br /> Specific Date Range of lnfonnation requested: F 622 W 11 TH ST, TRACY to <br /> ENVIR 624 W 11TH ST, TRACY <br /> UNDERGROUND TANK(UR CLEMUP STf'E(LOP) ' 626 W 11TH ST, TRACY SOLID WASTE FACILITYNOCCLE <br /> OTHER CLEANUP SITE(Nom-LOP) 628 W 11 TH ST TRACY " ❑WASCI«7utE <br /> UNDERGRouun TANK(MnNffORING1RFMOVAL) 630 W 1.1 TH ST, TRACY �DAIRY <br /> HAZARDOUS WASTE GENERATOR WASTEWAtER TREATMENT PLANT <br /> TIEFIED PERMITTED FACRiTY 632 W 11 TH ST, TRACY PUMPER TRuCKIYARDICHENCALTOU78 <br /> ❑TATrOOIBOnY PIERCING 634 W 11 TH ST, TRACY ❑LAND USE APPLICATION SMS <br /> } ] MEDICAI.INASTE FACILITY 636 W 11 TH ST, TRACY ` ❑OTHER(PLEASE SPECIFY) <br /> WELL.AND SEPTIC PERMIT RECORDS ARE Av 638 W 1.1 TH ST, TRACY 00 AM-5.00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to tan addresses in the space abo 640 W 1 1 TH ST, TRACY above by checking the appropriate <br /> box(es). At least one file type MOIST be 9 642 W 11 TH ST, TRACY I d ahv Address <br /> ranges will not be accepted-for addltlOn 644 W 11 TH ST,TRACY' >ie EHp• Applications received after <br /> 3:00 pm will be processed the next busin' 646 W 1.1 TH ST, TRACY 44 <br /> 2. The EHD will notify the applicant if any EI648 W 11TH ST, TRACY---N111 be Confirmed approximately ten(10) <br /> days after receipt of application. The file. 650 W 11 TH ST, TRACY `ss days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A filo that iz actively being worked on by 652 W 11 TH ST, TRACY le for review_ A new application may be <br /> subinI&d 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 same applicant may require a$125 deposit prior:to r1mew. <br /> ram USF ONLY' - <br /> Tn/T.h -7P1da 1NIdd IS Ad00 A.I.IO ZELGSS9Z5Tb 9Z:8T ZTEZ/ZT/L0 <br />