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DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ��� v ENVIRONMENTAL HEALTH DEPARTMENT <br /> �Jr y' t V y2/" 1868 East Hazelton Avenue , Stockton , CA 95205-6232 <br /> Telephone : (209) 468-3420 Fax : (209) 464-0138 Web: www.sjgov. org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: GOTTLIEB JOHN MARMET, ATTORNEY AT LAW BUSINESS/AGENCY: VON BRIESEN & ROPER <br /> ADDRESS: 411 E. WISCONSIN AVE ., SUITE 1000 CITY/STATE/ZIP : MILWAUKEE, WI 532024409 <br /> PHONE (1 ) : 414-2871533 PHONE (2) : 414-276-1122 FACSIMILE : 414-276-6281 <br /> ) <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. t <br /> ❑ CHECK BOX TO EXPEDITE REQUEST - $130 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT UNAVAILABLE - SEE ATTACHED LETTER ! ';'. ; : j DATE 6/2115 <br /> ell <br /> Electronic Information : ❑ List ❑ Map — Description : ell <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street # Street Name City ❑ Unit 1 <br /> 1 , 3900 HOLLY TRACY , Ie <br /> el 2. IfE] Unit 2 <br /> 3. ( <br /> 4. ❑ Unit 3 7 � <br /> 5• SITE MITIGATION <br /> 6. ❑,Unit 4 <br /> 7. <br /> 8. ❑ Unit 5 <br /> 9. <br /> 10. ❑ Unit 6 <br /> Specific Date Range of Information Requested: From to 1 <br /> ENVIRONMENTAL HEA TW OEVARTMENT FILES <br /> ❑ UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY ❑ SOLID WASTE FACILITYIVEHICLE '. <br /> ❑ OTHER CLEANUP SITE (NON-LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE <br /> ❑ UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY ❑ DAIRY <br /> ❑ ABOVEGROUND TANK ❑ CHICKEN RANCHI DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br /> ❑ HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑ TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ TATTOOIBODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6 :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 E <br /> box(es). At least one file type MUST be selected. Fax to (209) 464-0138 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 $125 deposit prior to review. "BOXED AREA - EHD USE ONLY" <br /> ❑ Records provided by Staff-PPR Complete, Staff Name: <br /> EHD 4M6 5/111'15 <br />