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Auo. 13. 2013 4: 28PM N0. 0021 EFP L20NUMBER <br /> Mu <br /> MV SAN .10AQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AUG 13 2013 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMITISEFMCES PUBLIC RECORDS RELEASE APPLICATION nn <br /> APPLICANT: Sara <br /> S► BUSINESSIAGENCY: feA bi Y <br /> ADDRESS, Re-- 9 N ° IYS� 4-4-a-c , �) CITYISTATEIZIP: ��Ft DSWLI -3 �Sll� <br /> PHONE(1): (�� (p0(0 r PHONE (2): (,r?-fF ,?9-?V1S FACSIMILErE ATIVE'APPOINTMENTDATE: Ue5 Z <br /> I�1S-l- Time: � <br /> (Please allow 1 o business days from date of applic mittal-'Tentative only-must be confirmed) "1i <br /> F1CHECK BOX TO EXPEDITE RE ST-$125 (C SH CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT BATE �I13[I✓ <br /> Electronic Information: 0List ap—Description, yh Or` 0� h a CQ 1i I aKd S <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> �e� Ct'"" unit <br /> V <br /> bo H tow w ve <br /> Trig L Unita x <br /> i <br /> r 0`5 <br /> 11110 Unit <br /> 7. <br /> Unit!5 <br /> 8. <br /> s d CJ ' ��cu L1 Y <br /> 10. p Unit s <br /> Specific Date Range of Information Requested: From <br /> G{5 Q Ar s to !' F7777', <br /> ENVIRONMENTAL HEALTH DPARTME T FILES <br /> dUNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY WAD TARE <br /> L'JS FACILITYNEHIGLE Nv <br /> [OTHER CLEANUP SITE(NOM-LOP) Q HOUSING ABATEMENT <br /> , NDERGROUND TANK(MONITORINGIREMOVAL) Q FOOD FACILITY i <br /> RY <br /> ST <br /> Q WASTEWATER TREATMENT PLANT <br /> ABOVEGROUND TANK E]CHICKEN RANCHI DOG KENNEL <br /> IJAZARDOUSWASTEIHAZARDOUSMATERIALS QMOTELIHOTEL V'I:�UMPEtTRUCKIYARDICHEMICALTOILETS <br /> IERED PERMITTED FACILITY Q POOLISPA NZ AND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING Q COMPLAINTIRESPONSE RECORDS Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PFRMIT RECORDS ARE AVAILAULE 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 209 464-0136 o the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses, contact the EHp. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. 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 /> 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 Jr.available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the ap Ilcant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ) o)E � 3 11�?^�� <br /> V_ <br /> R D Records provided by.Staff=l?PR Colrlplete. Staff Name: siaraz <br />