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DATE RECEIVED .1G SAN .lOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT 11 A <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �( /1�✓1.�,(r Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjg ov.org/ehd <br /> Ib(J PUBLIC RECORDS RELEASE APPLICATIQN <br /> APPLICANT:Tina Cheney BUSINESS/AGENCY: NWI�l O.Anderson&Associates <br /> ADDRESS: 902 Industrial Way CITYISTATEIZIP: Lpdi,CA 95240 <br /> PHONE(1): 209-747-0640 PHONE (2):209-367-3701 FACSIMILE:209-333-8303 <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-n%ust be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROG ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Tina Cheney DATE September 25,2013 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City / <br /> — El Unit 1 1 <br /> �,/ 1. 1340 W.Charter Way Stockton z'r S <br /> tA. 2. 1310 W.Charter Way Stockton uM �o cps ❑unit z <br /> 3. 1323 W.Charter Way . Stockton L sT' msP <br /> 4. 1245 W.Charter Way Stockton H N ox�vo cos <br /> E:fUnit3 <br /> 5. 1145 15 W.Charter Way StocktonT s <br /> 1 <br /> 6.. 1501 W.Charter Way Stockton tCsr enn4plgpq�P - unita � � <br /> 7. 1819 S.ArgonautSt Stockton U.S'r cusp <br /> 8. 1777 S.Argonaut St Stockton 40- c` CAS ❑unit s <br /> 9. 1745 S.ArgonautSt Stockton 11 D NoC-05P <br /> 10. <br /> ❑ unit6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY X $OLID WASTE FACILITYNEHICLE <br /> X OTHER CLEANUP.SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE �1)e 5 <br /> XUNDERGROUND..TANK(MONITORINGIREMOVAL) .. _. _ _❑FOOD FACILITY_ _... ._. . -. ._ _ . ❑..)AIRY �� --I_CD <br /> X ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT 16 <br /> X HAZARDOUS WABTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> X TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM.S:OOPM(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 pn <br /> 2. The EHD will nob I D-Z-1''� t 5101p �� CDOp��� �y� I y� 1'Il e • 21W 57'E0 <br /> CW2o1a In f �I2 Appointments (10) <br /> days after receipt (7p� GppD)'7a(p/p ,h }f /t"/ Appointments <br /> should be schedu 0 Irt i� COIF/�9l m 9W rik <br /> 3. submitted <br /> ted when active 3�10� 1/1 AST qIe C6 0003/Jj Irk HW �7/.� t application may be <br /> submitted when tt C!0000 ` CO000 SS52 <br /> 4. Any file not return(�Op 31oq(0 )./) �//Q 11, I gt'`� A)e_ of the applicant. <br /> Future file reviewE . rYIAI -04RR,.M ��370'7 L-t7 G`(J 3707/ I� r7 �✓i'IEC.. =A-EHD USE ONLY <br /> 1021 6(61 1U o / <br /> S. f. <br /> 1. :9 2 r l I f1- q <br /> MaJ z A 7 <br /> r-1Oernrrlc nrnvirinrl by C fnff.PPR CmmnletP. Staff Name- <br />