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low <br /> Jan. 13. 2014 1 : 29PM No, 0860 P. 1 <br /> i■ <br /> 1 ■ <br /> Io■ SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JAN 13 2014 1868 East Hazelton Avenue,Stocktbri, CA 95205-6232 <br /> Telephone:(209)488-3420 Fax: (209)4840138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEA13H H <br /> PERMIT/SERVICES PUBLIC R�CQRDS RELEASE APPLICATION12 Ij t <br /> APPLICANTBUSNESS1AGENCY: 61-(,,5 Frlut rdtj,"k��I x_,�, <br /> ADDRESS: 1.533 54sr& 9►,/'B9l <br /> PRONE(1):•&:5)135-T I ON Q PHONI?q):691 o)xyZq t y5 FACSIMILE-.610) irf_rf_ 9119 <br /> TENTATIVE'APPOINTMENT DATE: f J l-{ Time: % ,r 10 0/1, C. <br /> (Please BROW 10 business days from QM9 Wappnaatlon su m• 1-'Tbinadve only-must be confirmed)I <br /> CHECK BOX TO EXPEDITE REQUEST-$125 FETE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 9 BUSINESS DAYS LAJ <br /> SIGNATURE OF APPLICANT. DATE 12-�j a1►3 „� <br /> r. <br /> Electronic Information: ❑ List❑Map--Description: <br /> - •;FIILE ADpRE <br /> .at* <br /> ,!.stnrot. <br /> rit iJ rRe> <br /> `UnTt1� <br /> :!l;g. .:fly-:�•.. :;� <br /> Unit2 <br /> o <br /> f <br /> Un III <br /> §; <br /> G <br /> >; <br /> Unh <br /> 4 <br /> + <br /> CJ <br /> t <br /> Specific Date Range of InfonmUon Requested: From q I :_ ' to r <br /> ENVIRONMENTAL,HEALTH DEPARTMENT FILES <br /> UNDEROROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WA87E FACiI" 54 SOLID WASTE FACILITYNEHICLE ti <br /> OTHER CLEANUP$RE(Nowl.OP) HOUSING ABATEMENT WA=TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) HFOOD FACILrrY DAIRY <br /> ACOVEGROUNDTANK ❑CHICKEN RAHCHi DCA IthNNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WABTEiHA2ARDDUSMATERi t-8 MOTFjJHOTEL PUMPERTRUcKtYARDICHEmcALTOILETS <br /> TIC;;ED PER07EII FACILITY ❑POOLISPA LAND USE APPuw1oN 3m <br /> ic.,T001BOnYPIERCING COMPLAINTiRMSPDNSE RECORDS OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MogOAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uu to ten Idresseg In the space above. Select the type(s)of filed from the list above by checking the appropriate <br /> box(ea). At least one file type MUST be selected. Fax to(?Q9)484.0999 or mall to the address Indlijiltd imbove. Address <br /> 2nges will not be accepted-for additional aeeletance with file addrd"ea,contact the EHD. Applications recelved after <br /> :::4 pm will be proceased the next business day. <br /> 2, -:.•.u EHD will notify the applicant If any EHD filen exlaL An appolnIM66t for review will be confirmed approximately tan(10) <br /> ','s after reaelpt of application. The files will be hold for a maximurh 6f five bualneee daye for review. Appointments <br /> ,uld be scheduled acoordingly. <br /> 3. f,file that Is actively being worked on by EHD staff may not be Immediately available for review. A new•appllcatlon may be <br /> &;bmltted when the file Is available. <br /> 4. f..:!file not returned In the name condition as released will be reorganized by EHD staff at the expense of thea llaant. <br /> .:.ire file reviews by the same applicant may require a$126 deposit prior to review. aXSzF jP1 ► `t4 <br /> `� e' <br /> ' -U. •n, — il`� '.,,t ._. :.�'.�;.�. -.r R:',.:ll:c •��c„t;, '1�72. <br /> - -,:Ir>: :` _ ',:• 13•'••.•1'::=i -.alt' '7::.� .o <br /> 'S. <br /> .n r✓' <br /> rte, :,I�,• .'2•: ,I.1' 1.. 44„.I.,:•j,`,3n -'�• <br /> i te:.ataffNam <br /> ' r ovltled.bj'BtEtff�Wi'17 C cin e e: .•,,:� �:� ;: <br /> EMO•i•,F IWI <br /> Received Time Jan, 13' 2014 1 : 34PM No, 4993 <br />