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R5GOVED <br /> 9965 '°N' Wdel �106 pan aaa <br /> SAN JOAQUIN COUNTY <br /> 14 ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAY �. 2Q� 868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)469-3420 Fax: (209)464-0138 Web: www.sjgov.orglehd <br /> ENVIRONMENTALFUTISERVIC HEALTH <br /> F <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Sandra Maxfield BUSINESS/AGENCY.' Envir nm nt I QQst Managoment Inc. <br /> A©DRESS: 8488 Byron Highway CITYISTATEIZIP:�grentwoQd CA94,F0,j_,,_, <br /> PHONE(1): 925-525-4149 PHONE (2): 925-679-1059 FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arran a a I appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUE. .$ 5 F CAH Cl'tECK pNEY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTDATE <br /> Electronic Information: ❑ List❑ Map•-Descrip on: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street>x I Sheet Name city Unit 4 <br /> 2, Unit <br /> 4. E ! _ FIs • J1�4�� _ .Unit3_ f� <br /> - '- - t ` : -- �W0 • _ •,I/ r 1110 Cl/i r <br /> 0. _OF A_C60 aA, K+ate unit 4 <br /> 7. <br /> C)Unit 5 <br /> 9. <br /> 10. <br /> SpecJflc Date Range of Infomtation Requested: From 119c) to pq jL 2 e t!j _ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ERGROIjND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE EACILWYIVE:HICLE }' <br /> EDITHER CLEANUP SfTE(NON•LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE V fri I�E2 <br /> 3 NIIERGROUND TANK(MONrfoRiNWReMOVAL))� ❑FOOD FACILITY ❑DAIRY <br /> 1 <br /> ROVEGROUND TANK D� ❑CH1cKEN RANcFtl DOG KENNEL ❑WASTEWATER TREATMENT PLAW <br /> AZARDous WASTUHAZARDOU5 MATERIALS/ ❑MOTEL/HOTEL ❑PUMPER TRucKIYAR0JCH9MICAL TDILETs <br /> ❑TIERED PERmrrreD FACILITY ❑POOUSPA ❑LAND UsE APpucwiDN WES <br /> ❑TATToo/Smy PIERCING ❑ComPUUNTIRESPONse RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARI=AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDINL3 Hoo ioAYB) <br /> 1. List un to ten aadragn9g In the space above. Select tha type(a)of files from the list abovo by chocking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 4209)•4, 0138 or afI to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> Z. For assistance in Identifying the nature and content of EHD records,ploaee contact EHU at the number noted above. <br /> 3. The EHD will notify the applicant If any EHIO files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The files will be held fora maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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$125 deposit prior to review. 18QX92_AEFA_-KtP.USE ONLY" <br /> C.- <br /> L 1 P�11 <br /> ��r <br /> ik <br /> WAOX 5 1"'r # <br /> o a <br /> EAD4MG ?l4 10."V40 4120114 <br /> 7.�•� <br /> 0CTM1,Q4,CC1:D_01 C•!�l _U10J J �2C:C T. fiT.Gt�-CGi-1HI.1 <br />