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0 SOLID WASTE FACILITYNEHICLE
<br />[1] WASTE TIRE
<br />El DAIRY
<br />CI WASTEWATER TREATMENT PLANT
<br />PUMPER TRUCKNARD/CHEMICAL TOILETS
<br />El LAND USE APPLICATION SITES
<br />El OTHER (PLEASE SPECIFY)
<br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY S:00 AM-5:00PM (EXCLUDING HOLIDAYS)
<br />I. 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 he 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 />The EHD will notify the applicant if any EHD 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 should be scheduled accordingly.
<br />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 fife is available.
<br />El MEDICAL WASTE FACILITY
<br />HOUSING ABATEMENT
<br />11 FOOD FACILITY
<br />El CHICKEN RANCH/ DOG KENNEL
<br />El moTaiHoTp. El P at/SPA
<br />OMPLAINT/RESPoNSE RECORDS
<br />NDERGROUND TANK (UST) CLEANUPSITE (LOP)
<br />- 'OTHER CLEANUP SITE (N0N-LOP)
<br />NDERGROUND TANK (MONITORING/REMOVAL)
<br />B.OVEGROUND TANK.
<br />AzARD.pus WASTE/HAZARDOUS MATERIALS
<br />TIERED PERMITTED FACILITY
<br />El TATTOO/BODY PIERCING
<br />rom: Joe Carrey Fax: (888) 859-1312 To: Fax: +1(209) 464-0138 ,-ge 2 of 2 6/18 /2013 3:20
<br />DATE RECEIVED
<br />5 T" SAN JOAQUIN COUNTY
<br />ENVIRONMENTAL HEALTH D EPARTMENT
<br />1868. East Hazeiton Avenue, Stockton, CA 9520-6232.
<br />JUN J. 8 20-telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd
<br />.EN1.613,0-NP.,ENTAL HEPE1-1 PUBLIC RECORDS RELEASE APPLICATION
<br />EHD.LOG NUMBER
<br /><V11129'
<br />APPLICANT: BUSINESS/AGENCY: , .) ,e gri y.
<br />ADDRESS: r---t ... LL .9-- VP)1.---i-eida ---r-ery2 cp_glITY/STATE/ZIP: q6e4,41T r
<br />f .
<br />./
<br />PHONE (1): C,13--/ --=›o:-V> PHONE (2): ACSIMILE:
<br />TENTATIVE* APPOINTMENT DATE: 11/A- - e tee../e ' Time:
<br />(Please allow 'ID business days from date of application submittal , *Tantative only - must be confirmed)
<br />
<br />0 CHECK BOX TO EXPEDITE REQU 25 CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS
<br />SIGNATURE OF APPLICANT -
<br />DATE
<br />(91-7au
<br />_v.
<br />I Electronic Information: • Let -El Map - Description:
<br />FILE ADDRESS EHD USE ONLY
<br />El Unit 1
<br />Street # Street Name City
<br />' 1-4101 1-:,A,S 1-- Li e!
<br />E-_, Unit 2
<br />2. 2[(1 1,NOCri ted.A6LAvC %/kf 5 4-5,
<br />3 0-1/ / C_11,-. f, /4.1'4,, al I liv.- ,
<br />, Ertl n i t 3 4 . '),0 6‘.
<br />4 (---)._e rry (4 el'(_ ig 406 1 1-. i
<br /> / 17) le_ t ixs11--) ,
<br />1 le Kt 6/221) D-UnIt 4
<br />
<br /> --
<br />.,,
<br />0 Unit 5
<br />a.
<br />9.
<br />El Unit 6
<br />! 10.
<br />(K)
<br />pecific Date Range of 1 nfon-nation Requested,: From
<br />ENVIRONMENTAL HEALTH DEPARTMENT FILES
<br />to
<br />4. Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant.
<br />Future file reviews by the same applicant may require a $.125 deposit prior to review. :"BOXED Feat
<br />TISR4.0 ''.1 5.ilalckgf ?''' 2 t ' .. f-.-fga,
<br />,VI ''''''.5,1F' ' L --,': - ,:, ''" ' - ?-iq' .-11--'7; -,--ita..,.,"1,.:' ..' ' „, 4•1' ,.‘
<br />dik.,:,, ,.,-,,,,,,p,r 4'• ' 5 'A",.-1,4:' 4, :,,x --,=:: %, w„, - i__,_,_,*: - ,,.:. :p .,E,. „ ,2 ,,,, ,•,, , :,, _r , ..1,,,
<br />l'e0 ' S3 ,K04:::-A :st
<br />un en _ng
<br />4. : Of „. *ii.K r ...A _:,, .; -'-'-'.', „ 4,!. ' •"'i,,_. ..,''.! ' .,,: :_,--: - ,
<br />9/4/12
<br />Received Time Jun. 18. 201 3:20PM No._3429
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