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NOV-19-2014 WED 02:21 PM KLEINFELDER FAX NO. 8012613306 P. 02 <br /> Lam.■ ° EHD LOG NUMBER <br /> DATE RENOv Di 9 2014 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> EN%liRONMENTALNEALTH 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> r? <br /> PERMITISERVfAMphone: (209) 468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESS/AGENCY: ,rr��rFGr e6 <br /> ADDRESS, 02.00 _ CITY/STATE/ZIP: .Sder d,a<�s G <br /> PHONE(1): - PHONE (2): -7/m FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK SOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PRO CESSCD IN 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT A DATE—I/ / <br /> Eiectronic Information: ❑ List[N Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Sueetff StreENamo City Unit 1 <br /> G <br /> 2. p �Q4G� ✓� "rQAI , rA�S Unit2 <br /> 3, z.7G �2e TQAc� QY-I.N f <br /> Unit 3 <br /> 4. l <br /> o a Q aah e. <br /> t3. —rQ,�,y � v .✓ �Q7iG�� �- `l �/ uMt4 <br /> 7. zoaR.Gj.I 'rQAC <br /> ❑Unit 5 <br /> 9. <br /> Unit 6 <br /> 10. <br /> Specific Date Ranga of information Requested: From i 4 L/D to r' 2F <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES WASTE FACILITYNFHICLE <br /> UNDERGROUND TANK(UST)CLEANUP SITE(L-OP) ❑MEDICAL WASTE FACILITY SWASTE OLID SOLIDTim®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT O <br /> UNDERGROUND TANK(MONITORINWREMovAL) ❑FOOD FACILITY ❑DAIRY <br /> WASTEWATER TREATMENT PLANT <br /> [ ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL It` <br /> HAZARDOUS WASTEMAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYAftDICHEMICAL TOILETS <br /> 69 TIERED PERMITTED FACILITY ❑POOLISPA <br /> LAND USE APPLICATION SITES <br /> ❑TATTOOISoiw PIERCING N COMPLAINT/RESPONSE RECORDS Ej OTHER(PLEASE SPECIFY) <br /> WELL AND 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=91464-0138 or Mall 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 FHD will notify the applicant If any FHD flies exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recelpt 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 FHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. —BOX A EA- D USE ONLY <br /> =Recor�d!siprovjded taff-PPR Complete..staff Name: nelnv�a <br /> EHP 46-06 <br /> Received Time Nov. 19. 2014 1 : 34PM No. 7594 <br />