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- . .... . . ... .. . .. --- --- ....._ - <br /> 11/12/2012 09:54 92574660"`0 AEI CONSULTANTS PAGE 01/01 <br /> RIMMED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT �� <br /> NOV 12 2012 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 466-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> ENVIRONMENTALHEALTH <br /> PERMIT/SERVICES <br /> �` ,, PUBLIC R+�ECORDS RELEASE APPLICATION <br /> APPLICANT: r](J� &K �l,l`NI([ 1- BUSINESSIAGENCY: Abt n <br /> ADDRESS: CAA1Amici `ill Knb CITY/STATEIZIP:W6.[ :L' ( yK C11-I LlSf� <br /> PHONE(1): gti5 -14(9 WOL4 l PHONE(2): FACSIMILE:, �� (meq C� <br /> TENTAT/VE`APPOINTMENT DATE: Time: <br /> (Please stloW 10 business days from date of application submittal-•TerdaNve only-must be coMimted) <br /> CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REOU EST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 8"V^ v( �� DATE 1L IZl I'I. <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> 1 I�t'eot# Street Name City �� <br /> - E Unk 1 <br /> 4Ck (�k we LA ' 10 S DCk--Nn <br /> 2. 1"1"1 r�U <br /> r LTl _... i' G1 J'(( Una 2 <br /> 3. 1g3(, L ash i-lt4hway '-1 " <br /> a. i>�31y1 RODA <br /> lin <br /> 6. <br /> _..... <br /> 7. T' C. <br /> _Unit 4 w <br /> 8 — MAJ <br /> 1 <br /> 10, <br /> L!Unit 6 <br /> Specific Date Range of Information Requested; From to <br /> ENVIRONMENTA HEALTH DEPARTMENT FILES [15 <br /> SOLID TANK(UST)CLEANUP SITE(LOP) ['}'HOUSINGABATEmENT rr[1y5SOLID WASTE FACILITYNEHICLE <br /> Qt�yOTHER CLEANUP SITE(NON-LOP) [rEr-I�FOOD FACILITY I.JWASTETIRE <br /> [ UNDERGROUND TANK(MONITORING/REMOVAL) raDor KENNEL [DAIRY <br /> C HAZARDOUS WASTE GENERATOR q CHICKEN RANCH EVWASTLIMA7 ERTRFATMENT PLANT <br /> YTIERED PERMITTED FACILITY [91VIOTEUHOTEL �.2 PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> CKTATTOOBODY PIERCING QPOOUSPA L7 LAND USE APPLICATION SITES <br /> E rMEDICAL WASTE FACILITY ["COMPLAINT RECORDS <br /> ❑OTI'IER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List Up to ten add s es in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(ea). At least one file type MUST be selected. Fax to(209)454-0138 or mall to the address Indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. Applicrtlons received after <br /> 3!00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END 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 END staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4, Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$125 deposit prior ew. <br /> X�/( 1 H <br /> EHD 4e-05 <br /> enm <br /> Received Time Nov, 12. 2012 8: 56AM No. 1600 <br />