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vee 09/21/2015 12:36 9257466090 AEICONSULTANTS PAGE 01/01 <br /> ° <br /> c ° <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> BVED <br /> ENVIRONMENTAL HEAzLTii DEPARTMENT <br /> SCP SOS1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> - <br /> elephone: (209)468-3420 Fax: (209)464-0138 Web: www,sigov.org/ehd <br /> ENVIRONMEN ALHE,,LTH PUBLIC RECORDS RELEASE APPLICATION <br /> PES171 F C 'S <br /> APPLICANT. E�Il?0112e—rh C', Q_rn BUSINESS/AGENCY: F'I C0 VSWta't'11S <br /> ADDRESS: 2500 CF1­Y1%jno '�}l�blo — CITY/STATE/ZIP: minyo- G'P_2, _- Cgsq:� <br /> PHONE (1): a�_S 7j 6— Ca 01-3 PHONE (2): 510—(4 6( `7$( � FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 0'q1-2_11201S <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street# Street Name City <br /> 2. 2142-4 WQS'r- N oO—M i te C9V'-,— Unit 1 . <br /> i <br /> 3• ES Unit 2 <br /> 4. (�Zaeru�� pile 0(st Unit 2H <br /> 6. '2��I� Unit3 <br /> 7. Q/nit 4 <br /> 8. I _//^—'MITIGATION <br /> ` e <br /> 10. O'Unit 5 <br /> Speclflc Date Range of Information Requosted: From to Q <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FAcrLrrY ID WASTE FACILRYNEHICLE <br /> ❑✓O;HER CLEANUP SITE(NON-LOP) F I HOUSING ABATEMENT L�'WASTE TIRE <br /> 0 DERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY 10D <br /> GROUND TANK ❑CHICKEN RANCH/DOG KENNEL EWATER TREATMENT PLANT <br /> ZARDOUS WASTE/HAZARDOUS MATERIALS F-1MOTELIHOTEL PER TRUCKIYARDICHEMICAL TOILETS <br /> IERED PERMITTED FACILITY ❑P OLISPA ND USEAPPLICATION SITES <br /> ❑TATTOOIBODY PIERCING CO MPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(os)_ At least one file type FALIST he selected. Fax to(209)464-0136 or mail 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 /> 2. For assistance In identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD files ezlst. An appointment for review will ba 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 /> 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 5130 deposit prior to review. '*'BOXED ARE =EHD U6E ONLY"" <br /> r,��`.�eQ C �Q � �� �•�,1� �5`��1 �� e, ��. 1a�v�+�c� Fkr� �il�� �P 2 a`1 � zS d�" <br /> ❑ Records provided by Staff-PPR Complete. staffNeme: <br /> R e c e i v e d T i m e Sep, 21. 2015 1 ; 35PM No, 9609 7i15 <br />