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.ep2/17/Lg14 15:U4 rna 0013 44Z au� n / �f : , ` <br /> ■ ( aEfr <br /> EHD LOG NUMBER <br /> 8: DATE RECEIVED SAN JOAQUIN COUNTY � <br /> �n(``t ' I fE ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> FEB ZOIC Telephone: (209)468-3420 Fax: (209)464-0138 Web: vdww.sjgov.org/ehd4 pfi <br /> w_A;- PUBLIC RECORDS RELEASE APPLICATION £'7 <br /> , <br /> AtP'ONANTp I P ,� e_/J p/t/ BUSINESSIAGENCY: k _ Ii/P/L <br /> �//�!V/T �' � Cir� p <br /> ADDRESS: �j / 2 /v Lrcz F� Te. 16 2, CITY/STATErzIP: �2 Si✓0 `J377-Z <br /> PHONE(1): �9- 77'ISS 5`/ PHONE(2): Ste- (y47-7 �1z FACSIMILE: 5: - <br /> , 4,IY2- -96V <br /> TENTATIVE*APPOINTMENT DATE: t}/ Time: <br /> (Please allow 10 business days from date of appl,cSt,dn submittal-'Tentative only-must be confirmed) <br /> ­V4`ECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS rr/} <br /> S194ATURE OF APPLICANT )J. i� X X �V=-' 1 DATE <br /> Electronic Information; ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street# Street Name City ❑Unit 1 <br /> 1 tt95�S cttea oil / STm� •fi s. w r� asr ur�p /; I <br /> 2. �C ` IG, )� br a ^ JCCOS ❑unit 2 � y , <br /> 3. (0 6Ja+eIt lol ,� sT H J T Ocs7� <br /> 4. f 9 07 e. A "St) 4o M ^ ABY �Jcccsp u^,tlnit3 <br /> s t'o, Noc �p <br /> w kco>>ur3 <br /> J s• �S�S eR0 ee, /t d, a `�51ft�P� I ❑•Volta <br /> SDO P <br /> T8. L.}�J k `� bT 00 C.G.) tjA% N.)CC'tf❑units <br /> // ,1 /[ t3E)B'W111t3 U?. ('O�.r aIP <br /> o✓�r..iw <br /> w` <br /> L10. 7`� lam^ vT'- 'gl cDs"irK <y ❑Unit a <br /> 91 <br /> Specific Date Range of Information Requested: From to <br /> � ro ENVIRONMENTAL HEALTH DEPARTMENT FILES rr S <br /> S NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY <br /> E]SOLID WASTE FACILffYNEHICLE IFj Y I I2 <br /> rER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE CD <br /> d DERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY NH,Y� I <br /> VEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> c 7 RDOUS WA5TEIHAZARDOus MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYAROICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> 111 ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> In 1. List un to ten addresses in the space above. Select the type[a)of files from the list above by checking the appropriate <br /> � box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mall 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 /> V-p 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. Appoinbnents <br /> should be scheduled accordingly. <br /> ,aice, 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 /> w 4 Any file not returned in the same condition as released will be reorganized by EHD staff at the expnse of theme a 11cant <br /> s Future file reviews by the same applicant may require a$125 deposit prior to review. 199-.­1115.11-' _ <br /> T <br /> Z <br /> , <br /> Cr•Pi .. .: <br /> ' <br /> �arQd,g��d.. car 9fi_xz7 c�lu.ryl4nd-acT °r3�, - Glsi ' --` 4' <br /> �faoe �t.-i� fpF, l�t� t� Ntil Flle,y - -d514 P[� v,dFdWilt,rQntawpyO(rt0000 510 <br /> �r 41p38 ul F�r1dJ� did Lt&-3F Uttjp.P1D0 +0 R,,V r�q(AeSt (b4-4\0- L415T file lfY 1161 BPA tJE409 <br />