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DATE RECEIVED _ EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> j V 1868 East Hazelton Avenue, Stockton, CA 95205-62315 Q <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wWW.sjg ov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Tina Cheney BUSINESS/AGENCY: iI O. Anderson &Associates <br /> ADDRESS: 902 Industrial Way CITY/STATE/ZIP: Lc�bdi, CA 95240 <br /> PHONE(1): 209-747-0640 PHONE (2): 209-367-3701 FACSIMILE:209-333-8303 <br /> TENTAT/VE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-n%ust be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROG ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Tina Cheney DATE September 25, 2013 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1. 1340 W.Charter Way Stockton r ' �S El Unit 1 <br /> •2. 1310 `cj W.Charter Way Stockton F,N� <br /> NO cc>s10 ❑ Unit 2 <br /> 3. 1323 W.Charter Way . Stockton L sT MN asp <br /> 4. 1245 W.Charter Way Stockton <br /> P19-1 <br /> Unit 35. 1145 �S W.Charter Way Stockton sP <br /> 6.. 1501 W.Charter Way Stockton P t� <br /> .µms)' r`L� Unit 4 <br /> 7. 1819 S.Argonaut St Stockton U T ro'^� -_k C��;� <br /> 8. 1777 S.Argonaut St Stockton CCO 5p ❑ Unit 5 <br /> 9. 1745 S.Argonaut St Stockton ;J a7 N cc P <br /> 10. <br /> ❑ unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY X $OLID WASTE FACILITYNEHICLE <br /> X OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE (� 1=1 e`, <br /> X UNDERGROUND TANK(MONITORINGIREMOVAL) E]FOOD FACILITY_ ❑DAIRY <br /> X ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> X HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> X 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,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 pry � � <br /> iu-z-lam r_ f- 5iotp r C0W'a.-.�q-)qio ytti J-ile , P_zp� �c,e, <br /> 2. The EHD will notif, P J�. L.�t'l oc)�o� proximately ten(10) <br /> days after receipts �pp)� (pjp ;n }fC,J �n HZ� ►l2 Appointments <br /> should be schedu <br /> 3. A file that is active �_�O 3 �S I�/ CD 0 3 1-[? application may be <br /> submitted when tl LOf%C 0 00 l ffcJ �7 PP Y <br /> 4. An file not return �(p�� I�� I�l c� I/Z D CGO S5 5 Ire f/,j )C) e <br /> Y ('�p0 of the applicant. <br /> Future filereviewa j0ijp4(.. ir!I !1 .C� '�10-�� 0.o to o717wi��� <br /> -A-EHD USE ONLY <br /> 6Cb1 r -Ie / ' S. <br /> (L'L4=e,'n-F 1, X�'91 <br /> 177 �a. Z y c A <br /> 0 Records provided by Staff-PPR Complete. Staff Name: <br />