Laserfiche WebLink
NOV-19-2014 WED 02:21 PM KLEINFELDER FAX N0. 8012613306 P. 02 <br /> DATE RECI-1111-0 p SAN JOA UI COUNT <br /> Nov � ��► ; <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Agit l, g�r ?�?i";wEvS= F- 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> P;� ;�t it ��'�ITL phone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: P BUSINESS/AGENCY: C E <br /> ADDRESS: _�_ .� yd�i a® CITY/STATE/ZIP: c.r 4<6 c y7 i <br /> PHONE(1): G, PHONE (2): FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ®CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 13USINESS DAYS <br /> SIGNATURE OF APPLICANT A Fz;� DATE -It/ f 2/&c') -2 <br /> Electronlc Information: (] Wst[j Map—Description: <br /> FILE ADDRESS EHD usE ONLY <br /> Street# Street Name City M Unit 1_ <br /> 2. cep .tJ 7Qti�� ✓Q 7'�Ac "M � <br /> ih5`e Unit 2 <br /> t 3. <br /> 4- d oQ i 9-A e-V poopb c unit <br /> r-)® <br /> S. cc nt, -QA <br /> 6. te _ unit4 <br /> 7. <br /> f "F <br /> kb t TZACI tA u��i��« �►� r ,xc�,j <br /> B. 5 0'S L.A2 G?a C2- 2AG „s D a 3 r�cc- S ❑Unit 5 <br /> 9. <br /> 10. Unit6 <br /> Specific Date Range of Information Roquested: From /�L/D to e- kcc- <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILI'IYNFHICLE 2- {C� <br /> PS OTHER CLEANUP SITE(NON-LOP) F1HOUSINo ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINOIREMOVAL) FOOD FACILITY ❑DAIRY 11 <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL N WASTEWATER TREATMENT PLANT ` <br /> ®HAZARDOUS WASTEMAzARnous MATERIALS ❑MOTEL(HOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY ❑POOLISPA JA LAND USE APPLICATIDN SITES <br /> ❑TATTOO/BODY PIERCING ®COMPLAINTIRESPONSE RECORDS ❑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 types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209)461.Q_138 or mail to the ad Tess indicated above. Address <br /> ranges will not be accepted,Applications received after 3:00 pm will be processed the next business day. <br /> 3. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. The FHD 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 tiles will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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$130 deposit prior to review. '*"eOX A EA- HD US 0 Y" <br /> j- XS <br /> -G17S •�7 dCfi. .iso c)q 7 <br /> ]f <br /> s f� <br /> t q�71p l C• �(11Cd 9Uee t CC(' C[l.te \ <br /> ��i`SJG ` <br /> 6 e �` `I�7(� r'ra�° �c S �qW,, }��e� ) t.4.67 9Cu I� f�ifo a ('Phtt)wn_Tgi;cs��� V <br /> 0:cz e X17 0 1Cl T �- LI <br /> FHP 4MG 7' 1, j q_ACj_j AU{O;mob ) oyr-p- In *W •F°�c 08°01114 <br /> �tx»�.�z� -?sem- r-�cs�C-�i P,�u�id�c� ba.ca.t.i�o c��t:.'t.Q/" <br /> Received Tim Nov 19. 2 14. 1 : 34PM N , 75 4 '°' �P°�' �dS ,mmj� _wcL- ' 3`qo rate` P,,;�rcwt% n�•'�' <br /> uta t k-f /�� �I�"U +� st��� d � of-j"a«l-f-1 �*�d. Q��« c:a "1��s �.�xcL (usT f <br /> 3 B�lp f rcac`j til��1 t.is*uiF, uzyr ) Lui>-7� cc4-1-e1 <br />