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0 <br />RECEIVED <br />SAN-JOAQUINjUL '30 2018 Environmental Health Department <br />PUBLIC RECORDS RELEASE APPLICATfON <br />ENVI <br />PEIWIT/S <br />III -- �;91 Z47 <br />L�%^7 <br />A P P U C A N T,� E i st Aiw BUSINEss <br />ADDRESS: 1AGENCY:S;;Def Gas & II <br />PHONE (1)CITY)STATEIZIP. Sari Jc,_ cA 115 io- <br />PHONE FAX OR E-IMAIL' <br />Please allow 10 -business days from date of applicati <br />. On Submittal for the records to be available, <br />Staff will contact you to grange al,-VIllointment date and time to <br />SIGNATURE OF APPLICANT review the requested records, <br />1_ List DATE <br />List �t"add�rtks hi the Space b e-R&w, Address rangesWILL.led. Select the typo($) offilvs`jf—oMths ... <br />III! 'le type MUST be selected. Fax to (2091464-01-- all to the <br />list below by checking the appropriate bGx(es), At least one fi accop <br />addrkss Indi"ted Ow or mail to In cohd. <br />b c�4—Drn, Applications received attOr 3:00 pril will be processed the next <br />Z For assistance In identifying the nature and content of EHD records, please cnntatt EHD at the number noted below. <br />3, The EHD will notify the applicant If any EHD files exist. An appointment for re <br />days after facef view will be Confirmed approxiIatety ten (10) <br />Pt Of application. The files will be hold for a maximum Of five business days for review. Appoiniment3 <br />should be scheduled accordingly, <br />4_ Any Me 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 $152 d6lJosit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILASLE FOR REVIEW, MONDAY -FRIDAY $:DO AM-5-OOPM (EXCLUDING HOLICIA, .1 <br />wI <br />Electronic Information: EX:i L J C <br />S t Map — Description, <br />SPeCift Date Range Of Information Reques <br />led: From to 2 S <br />ENVIRONMENTAL ........ 7 <br />HEALTH OEPARTMENT I FILE ADDRESS I - <br />FILES t5p r c '2'ddresws only addmss ranges will not beam,,F�-L61j% <br />GIVIV!1 S"el Narniicliy <br />2358 VA/ --1+l 1 0 <br />MR ww' UVV u . smckton <br />©r -d Pfl—,01d 1 - I <br />2358 Waterloo Rd Stockton <br />UST <br />H'Azarta-1 2358 Waterloo Rd Stockton <br />0 F7t*L 23 5 8 Waterloo Rd �Stocktonj <br />r7 <br />0 <br />0 tv"i U." Aggj�1'2Afv'- S"m <br />YII ' P!vT" To'*m <br />0 <br />Lj fkw -a4m1 <br />Ll C?11IC*Vr, Aaleh . DX0 Kenn;F, <br />D kcal Wsvt Tact -'a <br />D <br />X1 ccmt'4w'! <br />123581 Waterloo Rd Stock -ton <br />—BOXED AREA EHO Q <br />A <br />Ci <br />Retards provided by Staff -FPR Complete. seg <br />ff Name: <br />MLI <br />"M <br />UPA <br />vs" <br />1868 E. HaZelron Avcr"-1,,& <br />9F20Y5 T 20�1 40-'15�34�-,Cl I F 2 i9 464-G-1118, <br />-)S <br />