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From:4Iarcus H. Bole & Assoc! 530+633+0119 016/2012 11 :28 #246 P.001 <br /> D G&LEHD LOG NUMBER <br /> H11V3H1ViN31NNOHIAN3 SAN JOAQUIN COUNTY <br /> JUN 26 2012 ENVIRONMENTAL HEALTH DEPARTMENT O <br /> ��dZ g�r N(�! 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMENTAL10Z 99N&,4t�one: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> GM="Iwo"I8 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �&/1 6DLE BUSINESSIAGENCY: Rel F-f &(CX_( t7 S <br /> ADDRESS: MO rp�l�,h ((/", CITY/STATE/ZIP: I <br /> r <br /> PHONE(1): 5s?D-y/57-66�3 PHONE (2): FACSIMILE: Fj 3D 63? WR <br /> TENTATIVE*APPOINTMENT DATE: '6--S�� Ot ,� yf/�. Time: <br /> (Please allow 10 business days from data of application mittal-'Tentatfve only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST- 25 FEE(CASH H K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ,Ia, �/�— <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City_ ❑unit 1 <br /> I <br /> 2. f U 1 '' <br /> AeAZ (—/SD -3 H ❑Unit 2 <br /> 3. <br /> 4. <br /> unrc 3 <br /> 5, <br /> 6. ❑UW6 <br /> 7. <br /> 8. <br /> Unit 5 <br /> 9. <br /> 10. <br /> ❑unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ��,�// ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> }UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHIC 77 <br /> ttTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE 7, <br /> 25-UNDERGROUND TANK(MONrrORINGIREMOVAL� ❑DOG KENNEL ❑DAIRY ,t,�+/��7 y <br /> �AZARDOUS WASTE GENERATOR � ❑CHICKEN RANCH N P �-L -I2- <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑WASTER TRUCKREA D/ T ICAL <br /> ❑PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY - ❑COMPLAINT 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 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 /> END USE ONLY <br /> EHD 48-e6 811111 <br /> Received Time Jun. 26. 2012 11 : 37AM No. 0363 <br />