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���� SAN JOAQUIN COUNTY• 1E" 'ON W A E106 'S •AON atoll PaAia3a <br /> *66V <br /> EHD LOG NUM13t:R <br /> �Ov O 5 Zvi ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> one: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> EN PE MITISEFtVICE � <br /> cc <br /> PUBLIC RECORDS RELEASE APPLICATION 1 <br /> APPLICANT: c ) 0 I�r]� ]y-IAt z (t. 1(x BUSINESS/AGENCY: *PbAwg(• Eli gZK pp ri A <br /> ADDRESS: y CITY/STATE/ZIP: I <br /> PHONE q qq- ( ( PHONE•(2): FACSIMILE: <br /> TEWTATIVE&APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data orappllcation submittal-`Tentative only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit <br /> 2. nit2 I` ' <br /> 3. <br /> 4. unk'3 <br /> 5_ <br /> nit 4 <br /> 7. <br /> 8. Unit 5 <br /> 9. <br /> 10• 11 3 ❑Unit e <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ONDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY E]SOLID WASTE FACLLRYIVEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONRORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> [ 'ABOVEGROUND TANK . ❑CHICKEN RANCH/1300 KENNEL 3INASTEWATER TREATMENT PLANT <br /> [�AZARDOUS WAsrE1HA7ARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDI.CHEMICAL TOILETS <br /> ❑TIERED PERMITTED 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 8:00 AM-S:OOPM(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(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 /> 2. 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 /> 3. A file that Is actively being worked on by END staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the ex en_se of the aP licant <br /> Futurefile reviews b the same applicant may require a$125 de oslt rlor to review. ... $ ` <br /> n:mxenm::n:anrfir.;;^:.::,.:::n:::Ium-:ar."r:;w.;:r:::^-:::g�:•;: :i??i8r!1•!i?!i!ifiil!01, ht1r!,MRS."! _F.i:a:ir.:r.:1«::r..F 6. . 'h m:i' !!!!Ji5!i!�r•:nr.mmm,:�••aP:i:•T.:-y11.0 <br /> ,.. ....1....•.. n . .. n •r m wnx: m!:-..t.»n,.,......cai u . .. :7 .,..a <br /> t :le to! I L.E'A!Siitll 1::91.;"vii:..._..N..;.J:unnalwaln:uunn:[y.-;�:•': "r"^ ::n ! aLizu!Imw:.'i'.. :i!^ii:E5s"•...Uffi dn:Ulni!!I ?uun:::S i I; ,•i!••::3:::a ara'tl tiii <br /> 1:•::••fir :1:•., ..., .. •T ._.. ;; ......ciFli•N!^9if.! <br /> Li!!iwli'� !NIi0 ..91Rifiihi!ilc ii i..'°?•�5'�'1i<'tjiliS'ev%�!1!ea•R�!I''!�-1?6:i ���iDi!f':.5tni:ii:^i"•. ,f' 'N•' ilL••; };•:111)to;rSCx#iCi4'.^u[�i�liEuiieeii!ii uei!tn:: <br /> 1:12101111, <br /> w R�_n:!r i!a'i�]l�IifuD!:Sii61�� �IN�l1 u(!{•rnlv�•.1 �• 1...:•, uJ:_... <br /> r _ .• a! prz: .EYSa':nP• ..am.. P.M?!^.?!;"Bc30ii!IP 9Ys3 H� ... :ce <br /> 1 .11. I nnotm -40142" .Yl Id.t:... ... r .ux_.�...• .. r;, !-y.;i. <br /> u„.x. l' i,a:ear ..'uki!!:T••xN• Y.E.. :L..... . ......................... . . .. ....... tl: ! <br /> _ <br /> II t_:' ...u. _.. • ._1.._^q:c•u_.w•..n............1u..n......v.1.1•n,•.1u;..�;;.n.....:•�• dill ! it Nltl: lY..;J:1:.1.'1: FI'::i�..;..._n^J:' .. <br /> i.t�::p•Ii1"i'ni:�t!�p 1 !g n• n: ::^•;Ii;eii: iiiiil!!iii:iiEi!Ji:?c:iF_:Illn:n :i!: r'( ^,ylauniilx,ufi::•aHu 9ltlt ILYIL:::C.IY']Ln9m:!C:1!!! ^. IL1i” i i�!ifii'n'l::Iaiii!!IICi.11]R <br /> I»11i I: i':al��[�'�i'vP!tF I ... "'!: f..:•^[:I: :SI:::�,::G:::::::::0:'��:T.t�: :IX:nn::Jnl�'! ': 1 :t9:::i�':1,i1:Ifi S:Y'I•,R:`Yfl:'ll:::l ••••:••:• [I.:It:::::'trJI:I L'll:l:l::'J. <br /> • •. •• •_. ""•^ :••��,��]:]!! 1g-r�':��..pmt ii •'yy((;tty1y��.�}y�tyy`��•��•yy"}}��.9'•. •.. •:: • I,!iI4fIH{:fxelii:�;vSS_'_�iiilnikiiiimlif!Cimla{ '1!fiiiiliiii"i!��``•!vl",i 1:: �.ai�::v::::u:ini£i <br /> ...... .. .:....SI .�fn a1.3s• �dd!ti..rf '.•..TIn6t'l).!SH,.�[.1•: 1 4 i.::l d":'.».::::::f. ,�.;;.. .:'.l":tlY:n:3�•.,P.:nSi..n'Jltn!I.ICT I 1::1... 1. <br /> EHD48-M914112 <br />