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ASCEIVED <br /> u <br /> SAN ., <br /> JUL 17 2014 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 363 East Hazelton Avenue, Stockton, f A 95205-6232 <br /> EI MENTA � forte: (209)468-34201 Fax: (239)464-013 r �b: . . rg/e <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION hR <br /> 3E �i 1 �APPLICANT: E <br /> ADORES 1 c °. ITYI TATE/Zna - ' <br /> PHONE(1): 9 it PH 0 N E(2):e`a`t FACSIMILE: it m ' tt4 @ e-1`` <br /> Please allow 10 business days from data of application Submittal for the records to be available. <br /> w <br /> Staff will contact y u to arrange an a I ppointment date and time to review the ra uasts r <br /> CHECK BOX TO EXPEDITE REQUEST- 25 FEE(C DSS H ONLY)- C T t�F� t € It � <br /> .,' S1 —N E E A PLl£� 1� _.. <br /> Elecrcic ttfcrrrsatian: exp— criptl : ` k "" r ..w. ` . ° v <br /> FILE ADDRESS----,-- OI USE ONLY <br /> Street _ Street Nerve It <br /> 0 6L <br /> 61 <br /> �* <br /> -50 <br /> 41 <br /> 16. <br /> -113 <br /> it <br /> m °. � ... <br /> trr�t <br /> g. <br /> 0. trr�lt <br /> Specific late Range of Information Requested: FrO to _. <br /> ENVIRONMENTAL HE rH DEP —Mff r FILES <br /> 3 RGRCUND TANK(UST)CLEANUP SITE(LOP), MEDICAL I AL WAS E FACILITY SOLID WASTE PAcILITAIVEHI LE <br /> "I HER CLEANUP SrC (NoN-LOP) HOUSING ABATEMENT �WASTE TIRE <br /> ERGII dere TANK(MONITC�WN I E OVAL �FOOD FACILITY �DAIRY <br /> PABOVEGROUND TA I{ [D HI EN AI`CHI OG$ 'IS I; � ATE�}A Eta TREATMENT PLANT <br /> TANK <br /> HAZARDOUS WASTE] RDOUSMATERMLS MOTELIHOTEL. <br /> PUMPRTUCKI <br /> Q TIERED PERMITTED FACILITY ]POOLISPA LACAfON <br /> tE <br /> El TA7TOOIBODY PIERCING OMP AINTI E PON E EcORDS OTHER PLEASE <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOP REVIEW: MONDAY-FRIDAY 8:00 Ate-S::{0PM(EXCLUDING f C:u Ay <br /> . Tn!g <br /> e se i Select the types)ref files from the list abov by.;checking the appropriate <br /> carr'fill ape4 4t�01 S or mail tri the address§redssated abrs e. Address <br /> esccetedb arra`will prciceed the next btlstrres day' <br /> 2. rl iderst fylrrg the nature err cc lsterst cr [ records,please contact EHD at the number noted above. <br /> G. The EHD will notify the applicant if any EHD fileexist. An appointment for review Will be confirmed approxirtt2t0ly tors(10 <br /> days after receipt of appliCati0m The files will b't held for a maximum co of five business days for review, Appointments <br /> should be scheduled accordingly. <br /> . Any file net returrsed 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$T deposit tenor to review. *-BOXED AREA-EHD USE ONLY*** <br /> rls rCtrra y-Staff- rrtltstftNarn ; <br />