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;.'02/17/2014 15:04 FAX 559 442 5081 KLEINFELDER I0UU1/UU1 <br /> 7 Yekasv�'' <br /> # sv <br /> :fE DATE RECEIVED - EHD LOG NUMBER <br /> SAN JOAQUIN COUNTYE C <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ` <br /> SEB 201 Telephone: (209)468-3420 Fax: (209)464-0138Web: www.sjgov.org/ehd W <br /> Hi��� t LAPPLICATIONo- <br /> A T: �LA�// e- / BUSINESS/AGENCY: <br /> ADDRESS: �j / /er•' G-Q-��( �Z`e l6 2-1 CITY/STATEIZIIP: <br /> PHONE(1): ,FJ- 77'AL!F? PHONE(2): S`�3 Lf7- FACSIMILE:<Q 4fYZ -96o/ <br /> TENTATIVE`APPOINTMENT DATE: Time: 1 ,�)/i"1 <br /> (Please allow 10 business days from datb of applecAIon submittal-'Tentative only-must be confirmed) <br /> HECK BOX TO EXPEDITE REQUEST $125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SI ATURE OF APPLICANT //j ,�. i ,' <br /> r t /X` DATE ryIL <br /> Electronic Information: 0 List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 2. ❑Unit 2 <br /> 3, yl (o [.va+grc Lo <br /> 4. `f 9 Q7 e. s la vo tit ' AS we ccs ^� unit 3 <br /> .5. <br /> nit4 <br /> 8- "f d W ►� }' N �jS txl _C RwAP Px-f-'Serj Units <br /> t+ <br /> • Unit6 <br /> tA Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 900 NDERGROUND TANK(UST)CLEANUP SITE(LOP) F1MEDICAL WASTE FACILITY [:]SOLID WASTE F"ACILITYNEHICLE <br /> OTH <br /> ER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT ❑WASTE TIRE CD <br /> ERGROUND TANK(MONrrORING/REMOvAL) ®FOOD FACILITY ❑DAIRY <br /> VEGROUND TANK D CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> aRDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMicAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> LZ ❑TATTOO/BODY PIERCING Q COMPLAINTIRESPONSE RECORDS Q OTHER(PLEASE SPECIFY) <br /> ® WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List ua to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> 4) 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-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 4- 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> - daysafter receipt of application. The files 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 EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> a 4. Any file not returned in the same-condition as released will be reorganized by EHD staff at the^expense of the a_plicanL <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. Ad k <br /> r: <br /> ............-..:i:'.9t::.:«:'•''..^.::.r::t:i:i:.^'::.:::: Syr...-.....«.......,..�...... - •:L:•.. A <br /> y! <br /> O yAc &�, .._ the-Ff �. Wl� •..111 .Y •� - 'i:•M : - -ss� - <br /> 6b6 7_t4;'7%q �� 1 t� II ® �LIftc sdur�6 Plc I- CY ,(V w:_._ 510 <br /> fi f lion u Akri�- caeca Lt&-3- F VU Jt0 •b roique,a-f P 0 5�r Me q(aqEk 0" <br />