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t,iT-22"=2014 07:33A FROM:GEOPHASE E�" 2095690295 TO:4640133 P.2 <br /> RE"IVEC! EHD LOG NUMBER 1 <br /> SAN JOAQUIN COUNTY �■1 <br /> 2 2 2014 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> € ARONMENTALHEATieLTti phone: (209)468-3420 Fax: (209)464-0138 Web: vlww.sjgov.org/ehd <br /> PImAA1T/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 57�aE Lp-ylj'16"d BUSINESS/AGENCY: r:'PO�`74Se <br /> ADDRESS: � ?37 CITY/STATE/71P: p rS CYJ <br /> PHONE(1): 56 9 mR 93 PHONE (2): FACSIMILL� <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal--Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE CASH OR CHECK O Y)-REQUEST PROCESSED IN BU (NESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Descr' Ion: <br /> FILE ADDRESS EHD USE ONLY <br /> r„ Street# Street Name City It'llt� <br /> 2- nt ❑Unit 2 <br /> 4• 1f ko" 17Unit a <br /> S. <br /> 6. -- dunit4 <br /> 7. <br /> 6. ❑unit 5 <br /> 10. --. <br /> ❑Unit 8 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICU/E� �� 3 <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE I HIP k/UlAl1 <br /> DINDERGROUND TANK(MONITOWNWREMOVAI ❑FOOD FACILITY ❑DAIRY If'r3 1 I-2 AL/ <br /> ABOVEGROUND TANK,?k F1 CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> 2fiAZARDOUS WASTEIHAZARDOUS MATERIALSOC ❑MOTELMOTEL E]PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOCI13ODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 1209)464-0136 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 /> 2. 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 <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 /> Future file reviews by the same applicant may require a$126 deposit prior to review. ''*'90 "REA EHD US19QN4Y <br /> _..f.. .S "I(' F.S '.1 4. <br /> x 7r s o n25--0 7 - 0 L 5 -07Q . <br /> I-x-14 SdL <br /> ❑ ReFOrds provided by StaffPR.Complete.Staff Name: <br /> EHe 49.06 9/4/12 <br /> Received Time Oct. 22. 2014 10: 12AM No- 7387 <br />