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RECENED 0 94 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAR 19 2014 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> EN%nRONMENTALHMT*phone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> PERMM/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: &,"14- BUSINESS/AGENCY: fit? f <br /> ADDRESS: l0 D � CITY/STATEIZIP: j—) b-LW1 <br /> PHONE(1): ` 'i GOIT PHONE(2): ()nob FACSIMILE: 1. If('17-- "3_6� <br /> TENTAT/VE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQU T-$125 FE ASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 7 <br /> Electronic Information: ❑ List❑ Map— escription: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 2. n A]Unit 2 !. <br /> 4. <br /> rat /Unit 3 <br /> t <br /> 6. <br /> k�h&101 <br /> ,r[] Unit 4 <br /> 7. <br /> 8' /Unit 5 <br /> IV <br /> 9. ,yam <br /> 10. CV� j ®L'J Unit 6,1 <br /> Specific Date Range of information Requested: From a to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILESrri . <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) J� FoOl) <br /> EDICAL WASTE FACILITY SOLID WASTE FACILITyNEHICL B <br /> OTHER CLEANUP SITE(NON-LOP) OUSING ABATEMENT WASTE TIRE - <br /> UNDERGROUND TANK(MONiTORINGIREMOVAL) FACILITY DAIRY A� <br /> ABOVEGROUND TANK o� HICKEN RANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS OTELIHOTEL PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY OOLISPA LAND USE APPLICATION SITES <br /> TATTOO/BODY.PIERCING OMPLAINTIRESPONSE RECORDS r OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 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(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 EHD 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 expense of the applicant. <br /> Future file reviews by the same app i nt may require a$126 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> n d in <br /> 1 ` (; <br /> ® Records provid d by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 9/4/12 <br />