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05/14/2013 08:27 FAX 9163722565 WALLACE-KUHL AND ASSOC. ZOOI <br /> DAF f2ECEIV'Eb-"� V <br /> EHD LOG NUMBEP <br /> :.�,���:a SAN JOAQUIN COUNTYENVIRONMENTAL HEALTH DEPARTMENT <br /> v1GY I ., 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <\ <br /> £iu'✓ ;J'N3U1tEPST'Ls=?,LT,1 <br /> PEP mid13E+?S%iCE16 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT- BUSINESS/AGENCY: Wel(aLc —k hl e AccoC <br /> ADDRESS: �'$bD SfYIC•J I�kvd CITYISTATE/ZIP: \0,& rYfrinmen�ai116 %1.oci.l <br /> PHONE (1): QI/a-3]1-IV3N PHONE(2): FACSIMILE: glte- Aja. •-;j&7, <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow to business days from date of application submittal-'Tentaffve only.must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 B,USI NESS DAYS <br /> .SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Description: ? <br /> FILE ADDRESS EHD USE ONLY <br /> ^ Street# Street Name City 0Uni <br /> J 1. - y L11) I Q A <br /> 2. g,Z 1 nit2 <br /> 4. -0 unit <br /> 5. <br /> 6. nit4 <br /> 7. <br /> $, ❑Unit 5 <br /> 9. <br /> 10. ❑Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FAC lYNFHIC <br /> THER CLEANUP SITE NON-LOP [I HOUSING ABATEMENT ❑WASTE Til hI(['-/7V/L I'U l <br /> OERGROUND TANK(MONITORINGIREMOVAL). ❑FOOD FACILITY El DAIRY ` <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> , <br /> AZARDOUs WAsTE1HA2ARDOU$MATERIALS A( ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TIERED PERMITTED FACILITY [:]f OLISPA ❑LAND USE APPLICATION SITES <br /> ElTATTODIBODY PIERCING COMPLAiNTIRESPONSERECORDS ❑07HER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE R 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(es). At least one file type MUST be selected. Fax to(209)464-0138 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. Afile 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$125 deposit prior to review. <br /> I(!1 �;.� <br /> ;IBM ;1 I I11 1a1111� .f ti' 1,51Rf fI I a•I �P.: 4� :,.� I1rI <br /> it II --il , <br /> ' ' . <br /> ,yi�µgyy <br /> lil' 1'} Ir��.),.�!'�,_ I(/4�'��/J n3' / -,Wi /Ii r/'1�-}il�tlJ� <br /> EHD M-06 � '11�I/ - r , „`Y 4 c �, V Kogl© 1 e c /�/f/G <br /> Received Time May. 14. 2013 8:41AM No. 3099 <br />