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DATE RECEIVED EHD LOG NUMBER <br /> JUIL 2 7 201 SAN JOAQUIN COUNTY .: <br /> ENVIRONMENTAL HEALTH DEPARTMENT ! �1 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> \ (� 'Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.s' ov.or /ehdY J9 9 , <br /> .J <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Joe Heneberry BUSINESS/AGENCY:GaiaTech <br /> ADDRESS: 135 South LaSalle Street, Suite 3500 CITY/STATE/ZIP:Chicago, IL 60657 <br /> PHONE(1): 312-262-4362 PHONE (2):312-545-5759 FACSIMILE: lnenebe��.�C7o ga;�ftcti.coV. <br /> TENTATIVE*APPOINTMENT DATE: Time: �— <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUE $125 FEE(CASCHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 1E_ H O DATE 7-27-2012 <br /> Electronic Information: ❑ List❑ –Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> ❑Unit 1 <br /> 1.� 4704 Fite Court Stockton 4I%i <br /> 2• ❑Unit 2 <br /> 3. <br /> 4. ❑Unit 3 <br /> 5. <br /> 6. ❑`f`Jnit 4 <br /> 7. <br /> 8. <br /> _ El Unit 5 <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From D\/o f/9lq 0 to ___7177-7 o%-LN <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE j -- L'-'� <br /> UNDERGROUND TANK(MONITORINGIREMOVAL). ❑DOG KENNEL ❑DAIRY I I I� Z-i Z <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA LAND USE APPLICATION SITES <br /> ❑ MEDICALWASTE FACILITY ❑COMPLAINT RECORDS OTHER(PLEASE SPECIFY) �� �ats,4�nuvc� <br /> er»,rc v�rnrnt e� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYSf eczr + <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. 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 /> 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 /> p EHD USE ONLYy- <br /> 5 i <br /> EHD 46-06 8!1/11 <br />