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<br /> !■ Sep-30-2013 11 :44am From-URS CORPORATION 2153671000 T-610 P.001/001 F-183
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<br /> �■ EHD LOG NUMBER
<br /> i� WJ SAN JOAQUIN COUNTY
<br /> ENVIRONMENTAL HEALTH DEPARTMENT
<br /> SEP 3 0 2013 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> Telephone: (209)468-3420 Fax: (209)464-0139 Web:wvw✓.sjgov-org/ehd
<br /> EWRONMENTAL HEALTH pugLIC RECORDS RELEASE APPLICATION
<br /> PERMIT P /}
<br /> APPLICANT: BUSINESSIAGENCY:�)�.�I '�Yc'lr�a X� t [e
<br /> ADDRESS: &ttCITYISTATE/ZIP: �7
<br /> PHONE(1): (a5) - Z I PHONE(2): FACSIMILE: 15 3( -7 Cnm
<br /> -
<br /> TENTATIVE'APPOINTMENT DATE: Time:
<br /> (Please allow 10 buslneas clays from date of aPpllcatlon submittal-'Tentative only-must be confirmed)
<br /> ❑CHECK BOX TO EXPEDITE REOUE -$125 FEE C, H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUST ESS DAYS
<br /> SIGNATURE OF APPLICANT I �- DATE fJ
<br /> Electronic Information: Q List❑ Map—Description:
<br /> FILE ADD ESS EHD USE ONLY
<br /> Street 0 Stmet NA a Ctty ,'{ � l F/I Unit 1
<br /> F12. vJeSF (Anr i �I "7 ` Unite
<br /> 4, Ci ti � UnR 3
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<br /> Ic? 7 �I l�`Unita I(
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<br /> 8. �:/1 l�� d�'-- -- - /-Fn %, C.i 71 Unit 5
<br /> 9.
<br /> L10. ., 40unite
<br /> speaiflo Date Range of Information Requested: From to
<br /> ENVIRONMdE TAL HEALTH DEPARTMENT FiLES
<br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLiD WASTE FACiLnyNEKcIE
<br /> OTHER CLFANUP SITE(NON-LOP) HOUSING ABATEMFNT WASTE TIRE /'
<br /> (� UNDERGROUND TANK(MONITORKGIREWVAL) FOOD FACILITY DAIRY
<br /> 4YI AI3oVEGROUND TANK CHICKEN RANCHI DOG KENNEL WASTEWATER TREATMENT PLANT
<br /> ' I HAZARDOUS Wa3TE1HAZARDOI}8 MATERIALSMOTEUROTEL Pumpm TRUCKiYARoICHEMrAL TOILETS
<br /> TIERED PERMITTED FACiLF1Y POOLISPA LAND USE APPLICATION SITES
<br /> TATi001BODY PIERCING U Compl.AINTIREsPOWE RECORDS OTHER(PLEASE SPECIFY)
<br /> ELL AND SEP nC;PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS)
<br /> 1. List U0 tQ t$n eddre55a$In the space aDOVe. 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(2 2)464.0138 or mall to the�ddr�aa Indlc�t4� y0 Address
<br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Appileatlons received after
<br /> 3:00 pm will be processed the next business day,
<br /> 2. The EHD will notify the applicant It any EHD files exist. An appointment for review will be confirmed approximately ten 00)
<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 retumed In the same condition as released will be reorganized by EHD staff at the expense of the appilcant.
<br /> Future file reviews by the same applicant may require a$128 deposit prior to review.
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<br /> EHD 48-N
<br /> aFutz
<br /> Received Time Sep, 30. 2013 8: 33AM No, 4173
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