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sd EHD LOG NUMBER <br /> HJ1yj—l.{-JVJN9�1040BI ND SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> DR 161 Z ddv,1 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:MlkeSonke BUSINESS/AGENCY:CardnoATC <br /> ADDRESS: 1117 Lone Palm Avenue Suite 201 CITYISTATE/ZIP:Modesto,CA 95351 <br /> PHONE(1): (209)579-2221 PHONE(2):(209)356-5018 FACSIMILE:(209)579-2225 <br /> TENTATIVE*APPOINTMENT DATE: Monday May 8,2013 Time: 10:00am <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQ125 F E(C R CK NLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> ES <br /> SIGNATURE OF APPLICANT DATE April 22,2013 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. 714 N. Hunter Nt<<- Stockton <br /> 2. 715 N. Hunter �GjjStockton p unite <br /> 3. 804 N. Hunter 61{i Stockton <br /> 4. 819 N. Hunter 'jSL`� 2A 6 6` ockton 19 LO6nit <br /> 5. 706 N. EI Dorado 3SZ Q Stockton D4Sj� <br /> 6. 713 N. EI Dorado Stockton nR4 <br /> 7. 725 N. EI Dorado Stockton 2 6 S <br /> 8. 804 N. EI Dorado yjK-1 Stockton 1 1 W C a-a-V1 11W ❑Unit5 <br /> 9. 212 W. Poplar hf fy Stockton C 4--fJ �r 1 13 <br /> 10. ( ❑Unit <br /> Specific Date Range of Information Requested: From to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYIVEHICLE <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> OR UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> Q ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> n HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> Q TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING D COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(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)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. 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 is available. <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 46-06 914112 <br />