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rom:GEO Syntee�Consulteix:(_0I&W6 9496Go:2094640138@rcfax.con Fax: +12084840138 91EHDLOG NUMBER 2 of 2 Oil 21201310:05 <br /> SAN JOAQUIN COUNTY _ a <br /> AUG 12 2013 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> EWRONMENTALHEhone: (209) 468-3420 Fax: (209) 464-0138 Web: vvww.sjgov.orglehd <br /> F'ERMTTISERVICES '' Ff .— <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:C'Ir.A�> rs}. . BUSINESSIAGENCY: Geoa;ylnic?c a <br /> ADDRESS: ISTATEIZIPnt <br /> PHONE (11): ljrI PHO jE (2) jk I04g7tJ7 FACSIMILE: , 63`_%2_ <br /> TENTATIVE'AI'F'C1E{4TMENTC)AT( IL. �L# 7 4; ,fir xs4&r TIM* / <br /> (Please a41ow 7u:buelrsass days from deta.ot cattonw1minaf--Tenet vson y-must bacon r ed) <br /> CHECK BOX TO EXPEDITE REQUEST- '12b•'.. (CASH OR,CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> .. ,._„n_.. .. <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑Map.—Description: <br /> ftk�kDDRESS .._ EliD USE ONLY: <br /> street# I Street Name cityUnit1 <br /> fs <br /> z. <br /> Ac.) r .. : ,. '�.: ..;:.!' --- f]unit 2 / <br /> S <br /> 3. &e [7 <br /> 4. qlllI f <br /> — iC `'int 2°l�a Unit 3. 11 <br /> y� ed <br /> ............... E . I IT& llti✓lt nit 4 <br /> 7. 0�'KvA .(� �I <1-1 -- I PiseoM 6Lo(<2 <br /> JD r . : 1 /� /NLl�l 3 unit 5 <br /> 10. ' ❑Unit <br /> Specific Date Range of Information Requested: From to .... .. <br /> Er,UNDERGROUND <br /> HEALTH DEPARTMENT FILES <br /> 1'�I.UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITYSOLID WASTE FACILITYIVEHICLE <br /> f1 DTHER CLEANUP SITE(NON-LOP) E]HOUSING ABATEMENT ❑WASTE TIRE <br /> Lg UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCHI Doc;KENNEL ©WASTEWATER TREATMENT PLANT <br /> HADRl,14119;yifAST JHAZARDOUe MATERIALS ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TfER6 PERMRTEO FACILITY ❑POOLISPA - ❑LAND USE APPLICATION SITES <br /> ❑TATTOoIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:00PM EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0135 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 /> 2. The EHD will notify the applicant If any END 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 /> 3. A file that Is actively being worked on by EHD staff may not be lmmediateiy available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any rile 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$125 deposit prior to review, "'®OxED ARE,fI� EHD US" <br /> J Z° -�� � r9M,",.t�„•xv'�'�alit.� 'h5$'.:dF x� L"-s � t �Syy�;- < �r:/' _' _. .` .. . q ry t:. :ue,�' v <br /> i"Im !s rttyr .. by Siaff=RRIgtt�P� .eL? " I .a° w L. <br /> EHD(a:os 9I4n3 <br /> Received Time Aug. 12. 2013 10:05AM No. 3852 <br />