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N06'11/2014 MON 13:07 FAX <br />I1■ <br />■ . ETr4E <br />_G1 IVED <br />• <br />C] <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />C <br />V D <br />L NUMBE <br />AUG I 1 Z014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov,org/ehd <br />ENVIRONMENTAL 1-il <br />P149MIT/SERVICES- PUBLIC RECORDS RELEASE APPLICATION <br />f� <br />APPLICANT:_ Lyla Gray-Etherson BUSINESS/AGENCY: Property Solutions Inc <br />ADDRESS: 323 New Albany Road CITY/STATE/ZIP: Moorestown, NJ 08057 <br />PHONE (1): 856-813-3000 ext245 PHONE (2): FACSIMILE: 856-813-1073 <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application 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 <br />DATE <br />Electronic information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />o <br />Unit 1 <br />Street # <br />Street Name <br />City <br />Country Club Blvd <br />Stockton <br />tJ i4 <br />Unit 2 <br />2.3. <br />r1�403 <br />�} p <br />� <br />Unit 3 <br />4' <br />Unit4 <br />li. <br />•...�.... <br />_...... _ <br />7. <br />Unit 3 <br />8. <br />units <br />10. <br />Specific Date Range of information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITYNEHICLE 10 cd <br />® OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY L] WASTE TIRE CD <br />® UNDERGROUND TANK (MONITORING/REMOVAL) El Dor. KENNEL ❑ DAIRY (�r2�� <br />® HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT Icy <br />❑ TIERED PERMITTED FACILITY ❑ MOTEIIHOTEL ❑ PUMPER TRUCKNARDICHEMICAL TOILETS <br />❑ TATTOOIgODy PIERCING ❑ POoUSPA ❑ LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY ❑ COMPLAINT RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 6:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List uo to ton addressea In the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At feast one file type MUST be selected. Fax to (2091464-0138 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 EMD files sxlsL An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will behold 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 applicant may require a $125 deposit prior to review. <br />Received Time Aug. 11. 2014 11:04AM No -6.795 <br />jZ d <br />