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DATE RFCFIIIED <br /> I <br /> a <br /> a 12 <br /> HD LOG NUMBER <br /> D12 VSAN LEND COUNTY <br /> CIL' <br /> �MA' <br /> Eta HEALTH DEPARTMENT <br /> RECEEL <br /> SEP 0 3 2015Talephori,1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> (209)469-3420 Fax: (209)464-0138 Web: Wvvw-sj9Ov,org/ehd <br /> EWII <br /> !_R,QNKENTALHFAjj-iI PUBLIC RECORDS RELEASE APPLICATI[ON <br /> PERMIPSERVICE_$� <br /> APPLICANT: Abby Racco <br /> ADDRESS: --4bZ LN. Qi2k St BUSIKIESS/AGENCY: Live Oak GeoEnvironm ntal <br /> CITYISTATEIZIP;J_QdL0AU14Q_ <br /> PHONE(1): _(209)369-0 75 PHONE(2): (209) 365-3222 FACSIMILE: <br /> 369-0377 <br /> FlOaSG 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 requeited records. <br /> CHECK BOX TO EXPEDITE ($0 <br /> 0 OR CHECK 01-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT REQUEST DATE q -3-1 S <br /> Information: El List Ej map Description: <br /> EHD USE ONLY <br /> Street# Street Name city <br /> 1. 550El u vt 1 <br /> W PVnIAIe1+ DA <br /> 3. 7 AA <br /> 11 11 _Ej U 142 <br /> 4. , 14(R 0 Eju i.t3 <br /> 5- <br /> C, <br /> 7. jfr(�, <br /> Units <br /> 10 <br /> Specific Date Range of Information Roque Fiom 0-unite <br /> ENVIRONMENTAL HEALTH DEPARTMENT REES— <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) []MEDICAL WASTE FACILITY 0 SOLID WASTE FACILITY/VEJIICLE <br /> OTHER CLEANUP <br /> STE"O"Lop) E]HOUSING ABATEMENT Ej WASTE TIRE <br /> iIGR .. A ORI ""OVAL) ❑ <br /> El POOL)FACILITY Ll DAIRY <br /> UNQEou 'T NG'F <br /> 0, NI <br /> ITABOVEGROUND <br /> 80VRL U )TANK ❑CHICKEN RANCH/DOG KENNEL 0 WASTEWATER TREATMENT PLANT <br /> HAZARDOUS <br /> W <br /> TIERED <br /> P�'MIT AST11 RDOUS MATERIALS OPUMPFRTRUCKIYA D/CHEMICALToatTs <br /> TED FACILITY 1-1 POOLISPA R <br /> LAND USE APPLICATION SITES <br /> ATTOOI PIERCING [X�COMPLAINTIRESPoNsE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> I <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:oopm(EXCLUDING HOLIDAY <br /> 1 addresses <br /> in the space above. Select the types)of files from the fist above by L <br /> to fe <br /> ng the nature and content <br /> U 8). At least <br /> one <br /> file <br /> typ heckling the appropriate <br /> box( <br /> anges'will not be accepted ted abova. Address <br /> 2. For assistance <br /> nce In Identify' business day. <br /> 3. The <br /> EHD will fy the pp number noted above, <br /> I'after receipt <br /> of application, <br /> confirmed approximately ton (,n)) <br /> should be scheduled review. Appointmonts <br /> y. <br /> 4. Any Me not returned in the Barre 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. ED AREA-EH <br /> USE ONLY­ <br /> El Gvl Records p;.rovi ;G by <br /> EHD 4448 1Complete.StaffNarno: <br /> 4n5/1 4 <br /> Received Time Sep. 3. 2015 10: 51AM No. 9483 <br />