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07 I <br /> V ..kj� 14159529421 ->12094640138 0 2 <br /> ME" I�DATE RECEIVED ii•�� SAN JOAQUIN COUNTY 40 EHD LOG NUMBER <br /> MY 0 1 2017 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton,CA 95205-6232 ?jG 0 6 <br /> !NMMNIVEN AL HE!lM Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/eh <br /> IFIITI8ER','3 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: A A BUSINESSIAGENCY: nth s 1 ` t r <br /> ADDRESS: IIIIP 1 rle— W> iwePj Sd i k. CITY/STATEMP: Son t.-- At e t c cr k g y 1I1 . <br /> PHONE(1): �, � 6 2'?6 PHONE(2): FAX OR E-MAIL:Nkpj�� <br /> Please allow 10 business days from date of application submitai for the records to be avallabib. I •C�,.1 <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> Fj CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 4aa _ � DATE (xsLQ 1 f z.0l 7 <br /> 1. List up to ten addresses in We space low. Select the tffopkoAffles from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 12091464-0136 or mail to the address Indicated above.i Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in Identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD files exist An appointment for review will be conflmwd approximately ten(10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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 some applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8,00 AM-5:00PM(EXCLUDING HOLIDAYS) ` <br /> Electronic Information: ❑List❑Map—Description: <br /> Specific Date Range of Information Requested: Front to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESSFILES I EHD USE ONLY <br /> UNmRoRmiD TAMC(KIST) street 0 Street Karns City <br /> CI.Emup SaE(LOP) r A" We riOtdUafiER <br /> �j'a _CLEANuP SITE(No+-LOP) <br /> S}iY.�� Tri c <br /> 4-HAZAROWS WASTE <br /> O'TtEUEo PEF40RTEO FACILrrY2 <br /> d 6 %L �, ' sf�� A DNRY <br /> ZfAwvEGRwNa TANKA �' <br /> � C <br /> BUST{IScxaiioRtNG/fO.WAL) � / ❑PWS <br /> 2fHAZOWOUS MATEMLS 3 <br /> �SPiLkiReEAsE REspaftw <br /> kfSauo STE WAFAcuN/VENICLE 4 ATEA m <br /> POOL <br /> ,F-ASITE M)MAT". <br /> LAND USE APPLICATION SITES <br /> SEPTIC Pu�rPEq TtttxK/ '"� <br /> ! a <br /> YARD/CHEMICAL TOILETS <br /> I/IyI <br /> WASTEWATER TREATMENT PLANT <br /> TK'HaL UW ASATSMEMT J G.1PA <br /> I A mOTEL&bTEL <br /> 01�4NICKrN RANCH/DDG KENNEL UPA-UST <br /> J' MEDICAL WASTE FActmy I <br /> i <br /> [6TATTOWBODY PIERCING I <br /> jEtVVASTE TIRE SDLID WA57f <br /> �`�cwPLAPrr ! <br /> 0OTNE2(PLEASE SPEC)FY): <br /> !0 ❑AccaurrN., <br /> I <br /> ! <br /> I <br /> 1 <br /> 17 Records provided by Staff-PPR Complete.sue► : 1 <br /> EMU-" <br /> Received Time May. 1. 2017 9 ;58AM No. 1356 <br />