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.A08/01/2014 15:44 FAX 0001/001 <br /> M <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> REOU'VED ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> AUG 4 74'eiephone: (209)468-3420 Fax: (209)464-0138 Web: www-sjgov.org/ehd <br /> EN�t�®Nt�1=���t ALTUBLI C RECORDS RELEASE APPLICATION <br /> APPLICANT: rte <br /> BUSINESSIAGENCY: -M-Ep'cek\� <br /> ADDRESS- X 51 12t' ivy JCn CITYISTATEOP: <br /> =bNaxk CA <br /> PHONE(1): Tt. 1490-13565 PHONE FACSIMILE:`T(0— —0Co <br /> TENTATIVE*APPOINTMENT DATE: $/H/20%S Time: 9:30 AH <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> []CHECK BOX TO EXPEDITE REQUEST-$12 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: [I List 0 Map—Description: <br /> FILE ADDRESS EHO USE ONLY <br /> Street# Street Name city ! Unit I <br /> g V <br /> ant,Q <br /> JrV1 <br /> 2- NO&jle�7 s6.. Unit 2 <br /> 3. <br /> 4. E]Un <br /> El'Unit 4 <br /> �ntt 3 <br /> '-i <br /> U.1 it 4 <br /> 7. <br /> Eunit 5 <br /> 9. <br /> 10. Alt rf-tgck - to IZI Unit6 <br /> Specific Data Range of information Requested: From <br /> ENVIRON N L HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLID WASTE FACLITYNEHipLE <br /> OTHER CLEANUP SITE(NoN.LOP) Housimo AsATEmEuT WASTE TIRE <br /> UNDERGROUND <br /> NDERGROUND TANK(MONITORINGIREMOVAL),L M FooD FACRm DAIRY 12—1 Ll <br /> ABOVEGROUND <br /> _V <br /> BovEoRoumDTANK ,-k_ ❑CHICKEN R04H1 DOG KENNEL WASTEWATER TREATMENT PLANT <br /> RDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIH6TEL 1PUMPER TRucKjYARo1CHEmicAL TOILETS <br /> ElTiERFD PERMITTED FACILITY EIPOOLJSPA []LAND USE APPLICATION SITES <br /> [-]TATToo/BoDY PIERCING- []COMPLAINTIRESPONSE RECORDS []OTHER(PLEASE SPECIFY) . <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR-REviEw: MONDAY-FRIDAY 8:00 Am-5:00pm(EXCLUDING HOLIDAY$) <br /> 1. List un 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 typo MUST be selected. Fax to(209)484-0138 gLmall to_tho address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. 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 top(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 now 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 END staff at the ex once of the a licant. <br /> Future file reviews by the same applicant may require a$126 deposit prior to review. <br /> M111"W"000"".0 1 Irl <br /> A <br /> -2 <br /> n <br /> L <br /> 1:0 Records provided.b�.Staff-PPR;:COW 1W... v <br /> 014M 2 <br /> Received Time Aug, 1. 2014 4:54PM No. 6729 <br />