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-234-0538 Line 1 0207:30 p.m. 11-27-2012 ill <br /> DATE RECEIVED LNU Luu NUMBttt <br /> RE <br /> V�O��� SAN JOAQUIN COUNTY <br /> V ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> NOV 2 7 2012 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> -ENVOGNMENTAL HEALTH <br /> `VRMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 141491K b6wr7 BUSINESS/AGENCY: 4�,_ Pia )/J���-f- <br /> /rte <br /> ADDRESS: /99 `l^- k �1�. % �� �e� CITY/STATEIZIP: <br /> PHONE(1): y QS�g PHONE(2): 4O -f0 FACSIMILE:-;�34/-053F <br /> TENTATIVE"APPOINTMENT DATE: Vn;J / fum ;?/j .2012 Time: �}/(JZ <br /> (Please allow 10 business days from date of application submittal.*Tentative only-must be con—firm d) <br /> kcHECK BOX TO EXPEDITE REQUESTCAFi4,0R CHECK ONLY)-REQUEST PROCESSED IN 3 BU INESS DAYS <br /> SIGNATURE OF APPLICANT DATE N <br /> Electronic information: [:] List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street# Street Name city Ll Unit 1 <br /> DV- 9aC6) S <br /> 2• 3j;Zftis ' fi5fl ❑ t 2 <br /> 3. C /Ulf)/?'/ R I r 7 ( 2 g , a <br /> 4. Q )'17ARiF? I e AP 'nit3 I� <br /> 5- 95SA4101 I�RMA Cgo UU�nIvr{/(/�t 3 y <br /> 0 l-471 <br /> 7. <br /> 8. To view the HMMP(Hazardous ❑units <br /> 9. Materials Management Plan)go to the <br /> 10, following website:www.sloesdata.org ❑Unit <br /> Specific Date Range of Information Requested: From <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE[ <br /> HERCLEANUP SITE(NON-LOP) `� ❑FOOD FACILITY ❑WASTETIRE � file-!!—'!' I81' &Pj <br /> 0 �LINDERGROUND TANK(MONITORINGIREMOvALJc7,,��� ❑DOG KENNEL ❑DAIRY 1Z pv/o It I(-A Z <br /> AZARDOUS WASTE GENERATOR ❑CHICKEN RANCH L]WASTEWATER TREATMENT PLANT. <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATrooIBODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND 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(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 /> r r <br /> I� Il i, ,i ?I 11 (t1 d qY <br /> Linvin AUAff2t431 Maj"rM- 4n <br /> I.z z • . 2,(4-31 I-a45°1 F <br /> Received Time Nov. 27. 2012 1 :30PM No. 1 P(UVt O6SiAhR� +"1 <br />