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❑O 10/09/2014 15:13 916--444-3541 FEDEX OFFICE 3295 PAGE 01 <br /> I ❑ <br /> °❑ -` � � ` ;j SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCT U a 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 (� <br /> Telephone: (209). 468-3420 Fax: (209)464-0138 Web. www,sjgov.org/ehd 1 l� <br /> pEp,v,n/6ERV!GES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: eKh E�r4y-zo` DUSINESS/AGENCY: CA-L :QC i <br /> ADDRESS: D Qegiao J27—1` CITY/STATE/ZIP:T <br /> PHONE (1): 6�s PHONE(2): �� FACSIMILE: _ U�� CYo <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange a pointment data and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST $1 �E 9G� ,}t ONLY)-REQUEST PROCESSED IN 3 8U IN S$DAYS <br /> SIGNATURE OF APPLICANT � � DATE Iv <br /> Electronic Information: ❑ List❑ Ma6—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City Q Unit 1 <br /> 2 r <br /> 1• � $ �;c� lv�or+ t�i1-EKY' �-kv�c�- Fnck�Y� �� -�/`"--_ <br /> 2. ; Z a o + ( Vl\+*"r �t reef- tock+mtn to�t31 t� <br /> ❑unit 2 <br /> 3-( as * g+. 14Dc, y, 4t3,54 <br /> 7. _ZdK Unit 4 <br /> 8. <br /> 9 _ ❑units <br /> 10. / <br /> a]Unit 6 <br /> Specific Date Range of Information Requosted: From to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL VVASTE FACILITY SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> --❑ABOVEGROUND TANK ❑CHICKEN HANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTFJHAZARDOUS MATERIALS ❑MOTWHCTEL ❑PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY POOL/SPA <br /> ❑TATTOO/BODY PIERCING E]LAND USE APPLICATION SITES <br /> COMPLAi r/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REy�Ew: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uo to ton addresses in the space above. Select the typ•a(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 2091464-0138 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 EMC)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$1:0 deposit prior to review. 'BOXED AREA-EHD USE ONLY`""` <br /> ❑ Records provided by Staff-�PPR-Complete. Staff Name: <br /> fEHD 40.06 �' 00!01/14 <br /> Received T�m`e Oct. 9. 2014 3: 10PM No. 7296 <br />