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Sep-13-2013 07:41am From-URS CORPORAT 2153671000 T-602 P-0011001 F-173
<br /> j I EHD LOG NUMBER
<br /> DATE RECEIVED
<br /> ■ USAN JOAQUIN COUNTY
<br /> ■
<br /> ■■ t:LjENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> SEP 1 2013 Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd
<br /> TH PUBLIC REOORDS RELEASE APPLICATION Ell r M:n 1j,
<br /> tt-
<br /> APBUSINESS/AGENCY:AD �,o ,v rc �y� __ CITY/STATElZIP: Cj J/t1/0A,4_& ph1 NOW
<br /> PHONE(1): o� ! �� ,j�� PHONE(2): FACSIMILE:
<br /> TENTATIVE*APPOINTMENT DATE: Time:
<br /> (Please allow 10 business days from date of application submittal-"Tentative only-must ba confirmed)
<br /> ❑ CHECK BOX TO EXPEDITE REG UE $125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUST ESS DAYS
<br /> SIGNATURE OF APPLICANT tf rte - -- DATE 3
<br /> Electronic information: ❑ List❑ Map—Description:
<br /> FILE ADDRESS EHD USE ONLY
<br /> Street# Street Name Clty- I Unit 1
<br /> lout /
<br /> W CZn4 [�(Unit 2
<br /> 4- C v �- __• L]Unk 8
<br /> 5.
<br /> 6 Unit 4
<br /> 7.
<br /> 8• 41 0-1/unit 6
<br /> 1!7113>q/Un its
<br /> Specific Date Range of Information Requested: From JY S, to
<br /> ENVIRONME TAL HEALTH DEPARTMENT FILES
<br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ML HEALTH
<br /> WASTE FACILITY SOLID WASTE FACILITYIVEHICRE
<br /> I(1v OTHER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT WASTE TIRE
<br /> I'l UNDERGROUND TANK(MONITORING/REMOVAL) FOOD FACILITY DAIRY
<br /> ABOVEGROUND TANK CHICKEN RANW DOG KENNEL WASTEWATER TREATMENT PLANT
<br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS MOTEL/HOTEL PUMPER TRUCKIYARD/CHEMICAL TOILETS
<br /> TIERED PERMITTED FACILITY POOLISPA LAND USE APPLICATION SITES
<br /> TATTOOIDODY PIERCING I 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 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 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 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 /> ,
<br /> 3—A file
<br /> that-ls actively being work®d-on by EHD-staff-may not be irnmediateiy avalla6ie for review. Anew 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 the applicant.
<br /> Future file reviews by the same applicant may require a$125 deposit prior to review,
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<br /> !, 'Wli' ripvd:iax .PP CB ^a
<br /> EHD 48-06 9/4/12
<br /> Received Time Sep. 13. 2013 4:30AM No. 4060
<br />
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