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' IK Irya�,�e�3 oi�i C� n M1:� 2016-08-08 05:23:33 GMT <br />jj �, l ori 't, ( (GMT) 18884443080 From: Pawel Woloszyn <br />DATE REUG 0 RUSH <br />to AUG O D 2(tn SAPI..OARUIN.CrOUNTY ..ee EMU�LQG.NU.MgEI{ <br />ENVIRONMENTAL HEALTH DEPARTMENT / <br />EN!`ENVIRONMENTALE�cALi�l 1868 -East Hazelazeiton Avenue, Stockton; CA 95205-6232 <br />CERMI(SEE <br />1TfSEMCES Tetephone: (206) 468-3420 Fax: (208) 464-013$ Web: www.sjgov.orgfehd <br />".., PUBLIC RECORDS RELEASE APPLICATION <br />0 <br />APPLICANT: <br />ADDRESS: <br />PHONE (l): <br />and time to review the requested records. <br />SIGNATURE OF APPLICANT ,:N„t''f./✓.,,,_.• <br />q-_: DATE (3!8/16 <br />1. List upto ten addresses in the spacebetow. Select the type(s)offles from the list below by checking the appropriate <br />bdz(es). At least one file type MUST be. selected. Fax to (2091 4644138 :or mail to the address indicated above Address <br />ranges will not be accepted. Applications received after 3:p0,pm will be processed the next business day.. <br />2. For assistance in'identifying -the nature and content of EHD records, please contact EHD at the number noted above, <br />3- The EHD will notify the applicant if any EHD files exist. An appointment for review willbe confirmed approximately: ten (1:0) <br />days after receipt of application. The files will be held fora maximum of five businessdays for review. Appointments <br />should be scheduled. accordingly, <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 fife reviews by the same applicant may require a$139 deposit prior to .review. ' <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRIDAYS:88 AM-5:1f8PM (EXCLUDING HOLIDAYS) <br />Electronic information: ❑ Ltst ❑ Map — Description: <br />Specific Date Range of Information Requested: From All available to <br />EidiYlRt'ttBMEtdTAti <br />KEAtT+1DL RTt f,L•' <br />FiLE:ADC3RESS <br />1 'e Uij j �S- <br />EHD USE ON —g <br />®uNOEACRouNO TArx;usTlStreet <br />Street Name. <br />City <br />t <br />2610.1. <br />Teepee �Dii e <br />���' <br />E�lp �(� 6CPRre...•. <br />N <br />trIZT cO! <br />C„EFruu?-Slre(LOFj <br />tlrNErs CeEANUPSrte fNwl:aP} <br />HA:A 3D WAsre <br />19 TsEFM PEMA yrrnm <br />ABQt'GROJYn TAM. (())i"�'__ <br />z <br />2455: <br />Teepee Dove e <br />. tackton <br />E3 Ln�cr <br />No <br />E) VST r�.¢n/A; "1 <br />+IAv,RDous MAncajw.s o vv <br />M $PtUR ZE - REsrQ GE <br />� swo WAST rA-a i vow' <br />�FMDFACLI <br />2365 <br />�Teepce Mve <br />5?:orl.'Fon, <br />II i.. l2pts <br />rVC� r <br />NO <br />4 <br />2735 <br />N- Teepee Drive <br />.. <br />Stocktnr <br />0 U W <br />5'a mr"A. <br />rI POO."SPA <br />�] Durr <br />i <br />ID LMD USE P�i IOfl SITES <br />b, <br />Y/ 2�! CNSticu Tatl.[Ts <br />WA�'Gi4'FTCATAEIm:'.ENS r <br />Q N04.dNG ADATE0.5EM' <br />r. <br />QUA <br />�FAQTELM1iQTa. <br />Cmcrw RpfKN 7.bn; NEN,gt= <br />CUPA. UET <br />r�-� <br />M MW; ' WA6 FACLLm <br />"e <br />TA'TRDIBODYPIERCING <br />® WAE T%E <br />�.CQuw✓nx4 <br />8 <br />�SOtfl.Wf81i. <br />)y) OTNCR(FLEAfiC-SPEpFYk <br />R�atet-uell &'Se}?ticSystem ' <br />ra <br />p Ac•1>�,,��. <br />•"DOXED AREA- END USE ONLY"' <br />rORec,,d, provided by Staff -PPR Complete- siax name: <br />END 4E46 <br />KecelVea lime Hug, !. [UIG iu:[[rm iuo. lull <br />0 <br />