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Ion. Manager Page 1 of 1 2014-12-08 17:06:04 (GMT) 2 r Michael A rt <br /> I ■ <br /> 14 <br /> 1553 238 From: u i e <br /> ■ DATERE.CEIVEf) SAN JQAQUIN COUNTY <br /> ■i <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 186a East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Tele hQlie.: 209 46$-3420 Fax: 209)464.-0138:Web:w vw,sjgov.org/ehd. <br /> .....eIep { ) { <br /> PUBLIC RECORDS RELEASE APPLICATION _ <br /> APPLICA.NT:.. I � �. '` LI1`l BUSINESS/AGENOY: I'}.r <br /> ADDRESS: i�� 't�`., 3I' �1t°r CITY/STATE/ZiP: r� a <br /> P14ONE(1): ���> "���% 14�fk;� RHONE(2): <br /> Please allow 10 business days from data of application submittal for the records to be available. <br /> Staff will contack.you.to arrange an:.ap.pointmenx,�Oe anal time to review the requested records. <br /> ❑CHECKBOX,TO EXPEDITE REQUEST-�Lo ASN C ONLY)-REQUE.ST,P.ROCESSED IN.3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS. EMD USE ONLY <br /> Street it Street Name CRY El Unit 1 <br /> 1 <br /> . 2. ��^^ o Unit �. <br /> l <br /> 4. nit 3 <br /> 5. <br /> 6. Unit 4 <br /> 7. <br /> �u t J. <br /> 9. <br /> 10. — El unit s <br /> SpecifLrr,Date Range of lnf.4.rmation Requested: From t4 (?-z' 'ivl <br /> ._..— <br /> ENVIRONMENTAL HEALTH DEPARTAglE T FILES <br /> iNDERDROUND <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) F]MEDICAL WASTE FACILITY ❑SOLID WASTE FACILfTYNEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> TANK(MQNIT:ORiNGIREmOvAL} . ❑FOoDFACILITY ❑DAIRY <br /> $OVEGROUND TANK ❑CHICKEN RANCH!DOG KENNEL ,• ❑WASTEWATER TREATMENT PLANT <br /> i° AZARDOUS WASTE/KAZARDOUS MATERIALS ❑MOTELIHOTE. ❑PUMPER TRUCKIYARD/CHEMICAL.To1LETS <br /> TIERED PERMITTED FACILITY ❑POOLISPA O LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑CoMPLAINTIRESPoNSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MoNDAY-I'R1DA1 u:OQ AM-S:QQPM(EXCLUDING HOLIDAYS) <br /> •1..List uo to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> )3ox(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 corrtact EHD at the number noted aboyq. <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 Field tQra ma:K r.urn of ftve.busfnass.days for_mviesv. Appointments <br /> should ba scheduled accordingly. <br /> 4, .Any file net returned in the sane condition as released will be; reorganized by EFiD sta.rf z-t the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review,- "—BOXE1)AREA-EHD USE 014 LY: ' <br /> ® Records provided Iay Sfi rff-PP,11 COmplcte. st<.PL name: <br /> -__ .•� ®. _. _ . . Dano r <br /> Received Tio)e Dec. 8. 2014 8:59AM No, 700 <br />