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MEN <br /> N M ��t1 ) No, 3554 P. 1 <br /> -r ""TO) <br /> 1y SAN JOA U N EHD LOG NUMBER <br /> Y� KI,l Q I. COUNTY <br /> %m ENVIRONMENTAL HEALTH DEPARTMENT 39 <br /> FFV RONtA EF4FAL FIENLTH 1868 East Hazelton Avenue, Stockton,CA 95205-6232 <br /> PEPdJlT/SEFN,10ES Telephone: (209)46"420 Fax: (209)4640138 Web:wvvw.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ashlen MCG=is BUSINESS/AGENCY: SJC public Works <br /> ADDRESS: 1810 E. Hazelton Ave CITY/STATE2IP; St0Ckt0n CA 95205 <br /> PHONE(1): 209-468-3085 PHONE(2): FAXORE-MAIL: 209-468-2999 <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 BOX TO EXPEDITE REQU 9 F_E_E CASH OR CHECK ONLY)-REQUESTPROCESSEDIN 3 BUSIN S_S DAYS <br /> SIGNATURE OF APPLICANT BATE <br /> I. List up to ten addresses In the space below, Select the type(s)of Flies from the list below 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.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EMD 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$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS u <br /> FILES EHD UTE ONLY <br /> Fi UNDERGROUND TANK(UST) Street# Street Name City , <br /> CLEANUP SITE(LOP) i.- 6 A' -F ,.[�Cor+eun,sa <br /> 9OTHERCLEANUP SrrE(NON-LOP) ' -5463 E Cherokee Ln Stockton <br /> grHAZAROOUS WASTE _ d DAIRY <br /> [TIERETT�DFACILm 2 1201 N Filbert St Stockton ` P <br /> �ABovEGROUNGROUND TANK s �) <br /> IiU <br /> grUST (MONITORING/REMOVAL) f (� PWS <br /> �HAZARDOUSWTERLAS 3 1111 N E St Stockton <br /> PILURELEASE REaPONSE <br /> SOLID WASTE FACILITY/VEHICLE a 2474 E Willow St � Stockton ofWAT�R QUALITY <br /> �ooD FACILfTY <br /> OOL/SPA 1 <br /> Stockton <br /> AIRY 5 <br /> 3507 S Odell Ave SITE MMOATION <br /> � �✓ _ <br /> LAND U5E APPLK:ATON SITES <br /> ❑SPPTIC PUMPER TRUCK/ , X ®HOUSING <br /> YARD I CHEMICAL TO= e 3146 S Odell Ave Stockton (\ <br /> WASTEWATER TREATMENT PLANT -a <br /> C M <br /> HOUSINRAHATEMPNT 7 2/"7 15 S EI Dorado St Stockton ©CUPA <br /> a MOTES/HOTEL <br /> G <br /> CHICKEN RANCH/DOG KENNEL d CUPA-UST <br /> I1 MEDICALWASTE FACILITY a 3690 S Turnpike Rd Stockton <br /> I3 TATTOO,BODY PIERCING <br /> i�C \ ,r1 <br /> A-,TE TIRE I�/ ' j� SDUD WA— 1 <br /> L J <br /> OMPWNT / 1 `/p q-r tq's I <br /> IJ OTHER(PLEASE SPECIFY): IV <br /> /� l M /I J <br /> TG (� u / /T 1 I ! �� �1L I�l f 2i-1742 <br /> I Ci ❑AccouNnNa <br /> !� ,//N <br /> ^'BOXED AREA-EHE USE ONLY"' <br /> ❑ Records provided by Staff-PPR Complete, staff Name: <br /> Received Time-Mar. 27. `2017- 2 : 59PM-No, 1108 <br />