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...... .......... -.... --------- ------ SO" " MhJC E106 'IE -,on, amij PaAiaDq �p�EC�IC� EHD LW NUMUEK p RGCEI V ED SAN JOAQUIN COUNTY 'ENVIRONMENTAL HEALTH DEPARTMENT ----- OCT 31202 1868 East Hazelton Avenue, Stockton, CA 95205-6232 q �� Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd ENVIRONMENTAL HEALTH PERMITISEERVICES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: SV�,eY)a BUSINESS/AGENCY: C1f'j^AtF6A �}I'l., t ADDRESS: �e . fU ttt-m-w CIIITYISTATEl21P: I -ne 6Yr A- PHONE(1): 5 f W2-1 I PHONE(2):5.i I St [ — J5- FACSIMILE:C55q -5;(-19 - '4 :Z Zg TENTATIVE`APPOINTMENT DATE: Time: (Please allow 10 business dayorom date of appl ation ubmittal-'Tentatfve only-must be confirmed) ❑CHECK BOX TO EXPEDITE R OUE $125 FE ( RC CK ONLY)-REQUEST PROCESSED IN 3 BUSIN DA4Q SIGNATURE OF APPLICANT DATE all Electronic Information: [:]List❑Map= scriptlon: FILE ADDRESS EHD USE QNLY Street# Street Name city C•� t 1. a A- w NAMM 2 Unit VV 3. 4. unit? S. Unit4 O T Q 8• IMUnit 5 9. 10. .-Unit s Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES O,UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY 79,SOLID WASTE FACIUTYaN^�EHICLEII ''Y �j ®•OTHER CLEANUP SITE(NON•LOP) F]HOUSING ABATEMENT ❑WASTETIRE /1 (;f h/I.C/Ift+r�• Z F4UNDERGROUND TANK(MONITORINGIREMOVALK ❑FOOD FACILITY ❑DAIRY e l l ABOVEGROUND TANK:>c ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT HAZARDOUS WASTEIHAZARDOUS MATERIAL ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS IERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES ❑TATTOO/BODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notifythe applicant if any EHD files exist. An appointmentfor review will be confirmed approximately ten(10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the ex ense of the applicant.: Future file reviews by the same applicant may require a$125 deposit prior to review. v jE ; kOilj �t,)Rfg'1 ...,...a• Av..au.:nn�cnn:•^::e ::rSio:A:{EEL.""lCvi9:::u�w,:.r.Sil.. �:e_::•.::r•- ••...•.. ..._.....-.._nsv:;::m.:w:mP:an,..._m:r_.uTv:r:..e::,_::ev��.:�::c-�_••:.:••c:ex::r:-:•:^:r'•:.._ '. ed .-�......_ ...........r.:. _._....-..... _.t... .......;.^.................. ..».. ':x.z v..uw .�... _...._...._........:c:.yV,EL;:vnInnw.ac::_Pa ....>....__r�u:::nss:::::;-:c1:.... t:z:?':E�-a••r.:, ,_.�:.c::..:__::.-•x»:cakTnvfl?uw::cm:e__w._.....r.:-.. .. _ i.•".Sil:E Ind:l..a.^.'w:n:.P.r..............n='.._...��...n.....r..n^........ ......._nw.......t:1I"l' PAJ:':::1: . .J 1 : Ti !i.l :w'1:..'.:.: .[!R!iC1•�::F-n:iA:a:l'.- ��.NSxP:R n a..:l.. �T.I.: �ic...�T..�;;wwnuwnnn nminimw:�xml•b:-r :nlul:nn:a:u^:mrc:m:.•xwx:::::::nr.:a:i?ilirissu:ueu;':D!?T:k^�t'� iin ilii^:F_..I;Es: - ........... ........ .. ... .,A •:umnrm:u:ersrcz'rr.; ::: s;..:Ap •- •i l^nv ,,.:,. vm..wa • : u a_.• ulra :::-•r.:rd•_••-': i i%Poiflitfi!;i:E�1ia4:if,a,?^iiii:ii'r'•PEMU'^?LEva.?ilh'E„•y. ulxw^.:::q!S`.r:;:`i:°'r' Ml H, a:nnxww"^•ii•ni:::i:aiieFw 4'� ..._ . .L.a.S._ir„E..tm;:;.wnn.nn.T!... ..... ...... ......... ..._.._v..l'_'m n�_.nr.•,.... III .I ., i.. ....y......;_.P:a•:: :rc^'f:!T !i: .......... ...._. _.. ...........yr:......': i. i Em .- K:....lax.-_Ir.....^......._.rfA:_......3:!Ea:•f•!•sE's::ama.Av..1_.z..,.z...'.'.e..m:.a:r.?u:m::un13!mn:i:^.emenin::::m:uxw.•.n;'y.rr'u,.^,;,r!c•;ii^'SRi!fiEr5i5Ei: iLa:ii - a ti:_:••_..:- _. k.;;rix:5^::x!.r_:.ra:wxarcmmmru::_.m:.lsmx:::rn:•ur•a.•=._^...... ...... ' 1f ERN C/J : .........prIRX.aL.It.Cn:,I:NI.EE ...,.... -- F.:6m.°. °uEma�'al'Jijnxrie E"D0.1�406 , 4,h +Iv,t+wa 5-rf/nyon .a u w:':�i !icii!F7 e,d,: