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EHD LOG NUMBER <br />of <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazeiton Avenue, Stockton, CA 95205-6232 <br />aiVIRONIVENTAL HEA141.4 Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br />r EMIT/SEES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Li ri colkt Pro perli e.-, BUSINESS/AGENCY: P.e,p,,Iia—tc;‘,71-1e <br />ADDRESS: ii,S—S-5-01 6,,,0 Joel elet-e._ •"'si'7 "e) CITY/STATE/MP: 40s 6..41eDs i ct, 4 93?, <br />PHONE (1): (Li(*) '3,90 —5-6.32 PHONE (2):)9q7-3-7Z 5 FAX OR E-MAIL: /i4coricIprt.,1,-,1-i..ez , ols— <br />Please allow 10 business days from date o appiication submittal for the records to be available. e 'ii/. caw, <br />Staff will contact you to arrange an appointmentMte and time to review the requested records. <br />0 CHECK BOX TO EXPEDITE REQUEST-7---S-P39 FEE (CA4OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT .4.e. DATE <br />1. List up to ten addresses in the space ow. Select th <br />•. <br />types) of flies from the list below by checking the appropriate <br />e selected. Fax to (209) 464-0138 or mall to the address indicated above. Address <br />Electronic Information; LI List E Map — Description: <br />Specific Date Range of information Requested: From <br />7_0(:)(..) <br /> <br />to <br /> <br />2.00 <br />! ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />. FiLE ADDRESS EHD USE ONLY <br />r ranTIDERGROUND TANK (UST) <br />CLEANUP SITE (LOP) <br />, 2 17:HER CLEANUP SITE (NON-LOP) <br />g6t'l-A-ZARDOUS WASTE <br />PrERED PERMITTED FACILITY <br />ABOVEGROUND TANK <br />ariST (MONITORING / REMOVAL) <br />AZARDOLIS MATERIALS <br />IR<L/RELEASE RESPONSE <br />Street # Street Name City <br />I <br />7&/ 5.-- 014-4<in0Air a-, 377),,,A/ <br />ifl CONSUMER <br />- .2- te---- <br />2 OVIIIV <br />0 DAIRY <br />D PWS <br />3 J__-' <br />, <br />4 g WATER QUALITY <br />/ <br />il SOLID WASTE FACILITY! VEHICLE <br />II FOOD FACILITY <br />Ici'VZIOL / SPA (..s <br />5 <br />F2j. SITE MITIGATION <br />ill DAIRY <br />[g.'D USE APPLICATION SITES <br />a <br />d'HousiN3 . SEPTIC PUMPER TRUCK! <br />YARD! CHEMICAL TOILETS <br />WASTEWATER TREATMENT PLANT <br />7 <br />CUPA <br />/ <br />Ergi7l1SING ABATEMENT <br />0 MOTEL/HOTEL <br />1111 CHICKEN RANCH! DOG KENNEL <br />8 <br />/21 CUPA - UST <br />. MEDICAL WASTE FACILITY <br />IIII TATTOO/BODY PIERCING <br />9 <br />El SOLID WASTE Il WASTE TIRE <br />ReC5rAPLAINT <br />gr'irfrER(PLEASE SPECIFY): <br />4;4;iff'S LI.61.-S° <br />10 <br />0 ACCOUNTING <br />‘"*BOXED AREA- END USE ONLY <br />0 Records provided by Staff-PPR Complete. Staff Nam: <br />r. DATERECEIVED <br />AU o <br />box(es). At least one file type MU <br />ranges will not be accepted. Applications received after 3:00 pm will be processed the next business day. <br />For assistance in Identifying the nature and content of EHD records, please contact EHD at the number noted above. <br />The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed apprcximately 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 />Any file not returned in the same condition as released will be reorganized by El-ID staff at the expense of the applicant. <br />Future file reviews by the same 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 />AR-nR