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EHD LOG NUMBER <br /> DAT RECEIVED SAN JOAQUIN COUNTY <br /> ` mA+�.h ;l ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> JUN 4 ?pgglephone: (209) 468-3420 Fax: (209) 464,0138 Web: vJWw.sjgov.org/ehd <br /> ENWR01*41VIEN'RLHEALTI, PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: F(lld,..tnu <br /> Cs,J 6 BUSINESS/AGENCY: <br /> 5 y,� <br /> ADDRESS: s ?t` S eo} Stilt ZZI1 CITY/STATMP: <br /> PHONE(1): 0 rl S•S I PHONE(2):, FACSIMILE: IS,Sq�• �� <br /> TENTATIVEtAPPOINTMENT DATE: rt Time: <br /> (Pleeee allow to buelnass days trom data of eppllc3r an submittal.•Tentative only-mm,be coniirmad) <br /> ❑ CHECK BOX TO EXPEDITE RE S 5 FE.,E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3,e*BU IINN/ESS DAYS <br /> SIGNATURE OF APPLICANT /!Y/l��r�/i� DATE <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS EHD U NLY <br /> Stmet N <br /> Street Name City- {y) ,yl <br /> 6T <br /> E,s¢ j1; vti lck � yT I M) <br /> 2. <br /> C b0 t. JJo CD un V <br /> Lem ( � <br /> 4. 316 F,a/ 437 ck W / �-L7 Unn a <br /> s. n/1 <br /> 6. <br /> -M-Unit a `LA$ <br /> 9� d <br /> 7 <br /> R. ❑Unit s <br /> 9. <br /> 10. i0- nit 6 <br /> specific Date Rang@ of Information Requested: From - to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES uD WASTE FACYITYIVENICyL�E� {zp <br /> DERGROUND TANK(UST)CLEANUP SIT;(LOP) ❑MEDICALtYIASTE FACILITY WASTE TIRE Q /^" <br /> (NHER CLEANUP SITE(NDN-LOP) ❑HOUSING ABATEMENT ❑ GI 5 <br /> I�j/ DERCROUND TANK(MONITORINGIREMOVALV< - ,❑FOOD FACILITY �Dg1RY Y J b 10 13 <br /> BOVEGROUND TANK t '❑CHICKEN Rmciil DOG KENNEL ASTEWATER TREATMENT PLANT <br /> �AZMDOUS WASTEIHAZARDOUS MATERIALS V- ❑MOTEUHOTEL ❑PUMPERTRUCI(IYARDICNEMICAL TOIIFTS_ <br /> IERED PERMITTED FACILITY (X ❑PPOOUSPA EILAND USE APPLICATION SITE$ <br /> ❑TATTOOIBODY PIERCING Q COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:ODPM(EXCLUDING HOLIDAYS) <br /> t_ List kip to ton 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(2 09)4 64-01 38 or Mail to the address Indio Address <br /> ranges will not be accepted-for additional assistance with Ilia 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 EHD file's exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be hold 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 returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> 5 <br /> Future posit prior to review.. --BOXED AREA- N�6r' <br /> YL ro hie reviews b the same applicant may require a�125 e <br /> F - - <br /> r . <br /> _ spa <br /> Received Time J n, 4, 20]3' 3. 1Illy,"ND. 3T72 2VPt5r0(0 <br /> ?11/bo /N'o Ile) <br />