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ROM ERAS Environm¢n2a1. Inc. CFnj>JUL 2T 2012 11:39 /ST. 11:39Mo. 7600000949 P 1 <br />I_■ �L/ EHD LOG NUMBER <br />��E® SAN .JOAQUIN COUNTY n <br />■i ENVIRONMENTAL HEALTH DEPARTMENT <br />JUL 27 2012 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 4640138 Web: www.sisov.org/ehd <br />oil. <br />Q* <br />ENVIRONMENTAL HEALTH <br />PERMIT(SERVICES <br />APPLICANT: I AV 1 <br />ADDRESS: <br />PUBLIC RECORDS RELEASE APPLICATION <br />CITY/STATE/ZIP: <br />PHONE PHONE (2 : FACSIMILfE�SIO <br />TENTATIVE' APPOINTMENT DATE: 2 Time: <br />(Please allow 10 businesst-'$125 <br />om too pp i ion submiHal - *Tentative only -must be conOnned) <br />❑ CHECK BOX TO EXPEDITE RE U E ( HECK ONLY) -REQUEST PROCESSED IN BUSIN SS DAYS <br />SIGNATURE OF APPLICANT DATE 17- 2 -- <br />,Electronic Information: ■ List ■ Map —Description:_ <br />- <br />■.END USE ONLY <br />��i�it� ■ <br />.■_ <br />J1�� F_05Ai Y��F!=j�--s�j� <br />MOT <br />1�► <br />10 <br />e. <br />Specific <br />Specific Daft Range of InformatIon Requested: From <br />,UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FAciuTYNEHIC ? <br />] OTHER CLEANUP SITE (NON -LOP)❑ <br />II E]FOOD FACILITY ❑ WASTE TIRE ID <br />HNDERGRouND TANK(MONITORINGIREMOVAL) 0--- DOG KENNEL ❑DAIRY <br />AZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TR TMENT LANT <br />-----IERED PERMITTED FACILITY 1't, ❑ MOTELIHOTEL ❑ PUMPERTRUCKNARDICHEMICAL TOILETS <br />] TATTOO/BODY PIERCING p POOLISPA ❑ LAND USE APPLICATION SITES <br />] MEDICALWASTE FACILITY ❑ COMPLAINT RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AMS:OOPM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses In the space above, Select the type(s) of Hies 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 Hles 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 />L•�GS /, '�1_Hn�rrz � FARM ,. f� fJi <br />Li.1 / '.%.J� Ali/i_ :� .01�l.' ♦!i �Ii i J.i i T.. <br />Received Time Jul.27. 2012 11:48AM No.0661 <br />