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.. ... ...... <br /> ----- ..... -Z- ...... <br /> -- ------ ------------ ------------- ... .... <br /> Mar/28/2013 12-30752 PM Salem Engineering Group Inc. 408 OE 1/1 <br /> EHD LOG NUMBER <br /> :MMM DATE RECEIVF-b)<,, <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH,DEPARTMENT <br /> 0�' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> phone: (209) 468-3420 Fax, (209)464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �0&LCkL BUSINESS/AGENCY: '�IUM <br /> ADDRESS- v�j ao)n TIM, Va . CITY/STATE/ZIP: SMftK-.. qC7111 <br /> PHONE(1): PHONE(2): <br /> SV4r FACSIMILE, <br /> I <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data otappucation submittal-*Tentative only.must be confirmed) <br /> 1j CHECK E30K TO EXPEDITE RET $126 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT REE <br /> . .-- DATE <br /> Electronic Information., []List L] Map—Description: <br /> FILE ADDRESS EHO U E ONLY <br /> Street 0 Street Name city Lj Unit I <br /> F-2. <br /> Unit 2 <br /> 3. <br /> 4. .-C]Unit 3 <br /> 6. <br /> yz -K6nit 4 <br /> 6. <br /> 0 <br /> 40 E;3 <br /> 7. <br /> /-0 Unit 5 <br /> Unite <br /> 110. i �• /I <br /> Specific Date Range of Information Requested: From ALA, to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE �jp s'u <br /> rUWTHER CLEANUP SITE(NoN.LQP) El Houma ABATEMENT ,WASTE TIRE <br /> 9 UNDERGROUND TANK(MON(TORiNGIREMOVAL) F1 FOOD FACILITY ❑DAIRY <br /> &ABOVEGROUNo TANK F1 CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTF-/HA7ARDOUS MATERIALS F-1 MOTELIHOTEL ❑PUMPER TRUCK[YARDICHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY F1 POOLISPA L]LAND USE APPLICATION SITES <br /> TATTOOIBCDY PIERCING M COMPLAINTIRESPONSE RECORDS [:1 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW' MONDAY-FRIDAY 8;00 Am-5:00m(EXCLUDING HOLIDAYS) <br /> 1. List yn-tgtgagiddress"in the apace above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one fila type MUST be selected. Fax to(209)464.01384rmail to the address indicated above. Addreas <br /> ranges will not be accepted-for additional assistance with file addressee,Contact the EIHD. ApplIcatIon5 received after <br /> 3:00 pm will be processed the next bUsIncee day. <br /> 2. The EHID will notify the applicant If any EHO flies exist, An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies 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 EHID staff may not be immediately available for review. A new application may be <br /> submitted when the file 10 available. <br /> 4. Any file not returned In the same condition as released will be reorganized by E1HD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$126 deposit prior to review. .Y.P. <br /> ........ <br /> .77-- <br /> Received Time Mar. 28. 2013 12: 31PM No, 2694 <br />