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NOV-19-2014 WED 02:21 PM KLEINFELDER FAX NO, 8012613306 P 02 <br /> f y "t <br /> - <br /> _ �, <br /> EHE)LOG NUMf'ER <br /> DATE RE^lOv pL g 20}Q SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> c k_iht 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �� . <br /> FS�VkFQk�N1ci fltLH- <br /> pEFitlrttTlSIF �phone: (209) 468-3420 Fax: (209)464-0138 Web: vvmwsjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> BUSINESSIAGENCY: <br /> APPLICANT;�R� n P Qr E <br /> ADDRESS: � J eFUo'/ 02 �C,do CITYISTATEIZIP:c ME <br /> S'— • 7/c a8b� FACSIMILE:: <br /> PHONE (1): tsar r �r 3z�� PHONE2,— ( )' <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK GOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 6USINES5 DAYS <br /> SIGNATURE of APPLICANT A Fre <br /> DATE- O ZG/° <br /> Electronic Information: ❑ List® Map—Description: <br /> EHO USE ONLY <br /> Unit <br /> FILE ADDRESS <br /> Street# Street Namo City t_ <br /> NDi7 ;.1ccASt CD <br /> U700 <br /> 'YCAe- UST unlit { <br /> 2, yo rRx, ✓45 3, z7G Teac, 00Y�14 <br /> �e l <br /> Unit <br /> 4. <br /> 5. Gc Q_Q- as <br /> TQ. G� l!$T tbcGor t Linit 4 <br /> 6. 7ILaG•/ A ✓ ^� t I.MWriks IIX <br /> 7. t A2L}f Q� t "TZAG <br /> 8. 5O',S L.A2G71 fY-;D I`I 0- :,bb ❑unit s <br /> 9, <br /> _ Unit is <br /> 10. <br /> Specific Date Range of Information Requested: From <br /> 4 to <br /> Ip <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES SOLID WASTE FACILITYNEHICLE (r�nCS <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY QWASTETIRE IIZd` ,7•i� <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING A9A7EMENT ❑DAIRY i 2' <br /> ®UNDERGROUND TANK(MONITORINOIREMOVAL) Foop Q <br /> CHICKEN CRANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> ®AeOVEGROUND TANK ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑❑MOTELIPATEL LAND USE APPLICATION SITES <br /> ®TIERED PERMITTED FACILITY ®COMPLAINTIRESPONSE REWRDs ❑OTHER(PLEASE SPECIFY) <br /> El TATTOOISOOY PIERCING <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILA9LE 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 he selected. ax to 209 46 - 38 or a to thea ess In catad shove. Address <br /> ranges will not be accepted,Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in Identifying the nature and content of EWD re far reviews, please contact <br /> be confirmed approximately ten(10) <br /> 3. The EHD will notify the applicant If any EHD files exist. An appointment <br /> days after recelpt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. ed will be reorganized <br /> FHD <br /> pense of the <br /> 4 Any file <br /> filereviews returned <br /> by the same applicant may lease a$130 deposit prior t yreview. atthe <br /> AREA- HD USE ONLYFut "" <br /> SJ-ci75$ 4.a7 'T vA • taT-w 7 <br /> X <br /> )2ISi4 � ' tja.7t 'irr • Ahierian Gu" <br /> due ID /s <br /> d.,c79 r.....-1 1£il�.:,s ('YA'vv;.,n_T rmV U A I <br /> e" For `I1')tei-nw (edS wiwle ) - e �9tto'T cu .r " S A(}Df�'343.C1 OsCif OeloVta <br /> rrza r qu a akro srop) oyK In µv ,PtLe. ProJidcd' /0-"U46 C <br /> FHP 46-06za.�.uS' ''.�'1D L '1htCL-Waoh 3q-lo —jraOL.. Y/OV <br /> Received Timg Nov19. 2 14 1 : 34 M NQ 75 4 7;°o T 'nfor G S ( e^�✓GI <br /> ulA lLk-E nui n1ck�A {c Skp) '�i b tilTau� Ile �*�• Pryoiciecf Co 3"7k�5 Tcxt'� uST ,rtsk � l <br /> 3q 1p rtzcH (A-.,t-+off, uai ) zoie70CP*rcl No low Giw), <br />