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ALG -30-2013 11:20A FROM:GEOPHASE"FNV 2095690295 T 1640138 <br />rAl(— "VED <br />ED SAN JOAQUIN COUNTY <br />AUG 30 2013 ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />ENVIRONMENTAL HEALTH phone: (209) 468-3420 Fax: (209) 464-0138 Web: www,sjgov.org/ehd <br />PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />DV— <br />off" <br />APPLICANT: <br />P.2 <br />EHD LOG NU�MB�F_,R <br />LF (, l <br />ADDRESS: I9%q � Jyp�� �( 'ees i G y Ty -e Citylstaterzip <br />�/ <br />PHONE (1): �/` / '3 P14ONE(2): - FACSIMILE: <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal -'Tentative only - must be confirmed) <br />,.-�CHECK BOX TO EXPEDITE REQU ST -5103 FEE CASH OR CHECK O LY)- REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 6 <br />Electronic Information: ❑ List ❑ Map- Description: <br />FILE ADDRESS <br />Street Name <br />I%a ��,• (• /r Care/a <br />/i <br />_ �� aF <br />_.. -._. _ <br />City_ <br />_ /'_lo_ r_rc4-- <br />i� <br />EHD USE ONLY <br />unit <br />NM fr co <br />street Y <br />1- <br />z._ <br />g� <br />a9z_ <br />j�j r N �`> ❑ Unit2 <br />�Z nx�Loi <br />��--- <br />4. <br />5• <br />]Unit7 <br />g110.0. <br />Specific Date Range of Information Requested: From <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />yq <br />ZUNDERGROUNO TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITYIVEHICLE a <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE t� <br />UNDERGROUND TANK (MONITORINGIREMOVAL)S-•J 0 DOG KENNEL 13 DAIRY u <br />0 HAZARDOUS WASTE GENERATOR 11 CHICKEN RANCH 13WASTEWATERTREATMENT PLANT <br />TIERED PERMITTED FACILITY 0 MOTELIHOTEL Q PUMPER TRUCKIYARDICHEM TOILETS <br />TATTDOIBODY PIERCING 173POOL/SPA ,❑r LANry''S�/ APPLICATION SITES <br />O MEDICAL WASTE FACILITY 0 OTHER (PLEASE SPECIFY) /`/ S <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW. MONDAY-FmDAY 8:00 Am-6:DOPM - EXCLUDING HOLIDAYS. <br />1. List Up to ten addresses In the space above. Select the types) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (2091464-0138 or mail to the address indicated above. Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications recelved 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 $106 deposit prior to review. <br />F W rr I ICF r1Nl_y <br />t - r �iil�/4 <br />iii i'...r1—., . ri <br />�� f Li.. • i/ /..i_-----Gl_f3T.iLTdf�F-f <br />3 /ffewl <br />'EHD 48-06 8104108 V - r <br />Received Time Aug,30. 2013 1:47PM No.3953 <br />