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��. Sap-1372013 07:41 am From-URS CORPORAi 2153671000 T-602 P-001/001 F-173
<br /> e: GATE RECEIVED EHD LOG NUMBER
<br /> USAN JOAQUIN COUNTY
<br /> eBE cEWED ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> SEP 1 2013 Telephone; (209) 468.3420 Fax: (209)464-0138 Web: vJww.sjgov.org/ehd
<br /> TH PUBLIC REPORDS RELEASE APPLICATION
<br /> AP�1C'ANTE�C YBUSINESS/AGENCY: rU ��
<br /> ADDRESS: � ,v,ny�c �r-�V C� CI tY/STATE/ziP: ,�/Y4 'P/y, JgQ^W
<br /> PHONE(1): � 1-6,3(,_7 PHONE(2): FACSIMILE:
<br /> TENTATIVE`APPOINTMENT DATE: Time:
<br /> (Please allow 10 business days from date of application submittal-"Tentative only-must bo aonfirmAd)
<br /> ❑ CHECK BOX TO EXPEDITE REQUE -$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSI ESS DAYS
<br /> SIGNATURE OF APPLICANT DATE 3
<br /> Electronic Information: ❑ List❑Map—Description:
<br /> FILE ADDRESS _ EHD USE ONLY
<br /> Street# Street Name City ,QUnit
<br /> Ua 1. � � �A 1 Oul ,•, I��QJ No C.d
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<br /> 1�� 2 \� pl• �• ot-cc' DUnIt2
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<br /> i Unit 9
<br /> 6
<br /> k7 Unit 4
<br /> 7.
<br /> Unit ti
<br /> 9.
<br /> 10. L�'UnIt
<br /> Specific Date flange of informatlon Requested: From to Hl�'
<br /> ab)
<br /> FNVIRONMI= TAL HEALTH DEPARTMENT FILES .f�I � •(�,
<br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLID WASTE FACILITYiVEHICLE Q
<br /> i6 OTHER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT WASTE TIRE I I
<br /> UNDERGROUND TANK(MONIToRiNOREMOVAL) FDOo FACILITY DAIRY /
<br /> ABOVEGROUND TANK CHICKEN RANCHI DOG KENNEL WASTEWATER TREATMENT PLANT
<br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS MOTELMOTEL PUMPER TRUCKIYARDICHEMiCALTOILETS
<br /> TIERED PERMITTED FACILITY POOLiSPA I-AND USE APPLICATION SiTES
<br /> TATfoo1BODY PIERCING COMPLAINTiRESPONSE RECORDS OTHER(PLEASE SPECIFY)
<br /> ELL 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 Dy checking the appropriate
<br /> box(es). At least one file type MUST be selected. Fax to(209)464-0139 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 END files exlst. An appointment for review will be confirmed approximately ten(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 activelybeing avorked on by EHD-staff rt ay not be lmmetl(ately available for rev ew, 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 EHD staff at the expense of theapplicant.
<br /> Future file reviews by the same applicant may require a$125 deposit prior to review.
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<br /> EHD 48-08 914!12
<br /> Received Time Sep, 13. 2013 4:30AM No- 4060
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