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is '2012-08-09 19:44 71 P 1/1 <br /> �7 �� R <br /> 1 201 : <br /> F 2P 1/1 <br /> Aug. 3. 2112 1! :WN, San JoaQuin County <br /> f <br /> EHC LOG NUNiMR <br /> ""EIVED <br /> SAN JOADUIN COUNTY <br /> fqE%i ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 Eaet Hazelton Avenue, Stockton,CA 95205-6232 <br /> Telephone:(209)466-3420 Fax:(209)464-0138 Web:wvvW.5j9ov,ora1ehd <br /> ENVIRONMENTAL HEAI_TA <br /> PERMITISERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPI•ICAN 1'� `� .r LC ( t _ ElUSINE:9S/AGENCY: p� �.,I '']]t� -✓ �` <br /> '�+ CITY/3TATE2IP:_L- nq <br /> ADDRESS: _ _V ).� <br /> PHONE 0): �tg PHONE(z�: pAC41M1LE: -,;� <br /> ]TF.AITA7lVr-APPOINTMENT DATE: Timo. <br /> (Ploaw miow io Lmsiriess daysfrom data ut application submittrt-`Tenhtive only•Masi be aonrlrmeq) <br /> I_I cl IECK 80XTo EXPEDiTF.PriQUEST-Sl �FF ( R - EST PROCESSED IN 3 9USIN C7 <br /> SIGNATURE OF AFFLICANT4.._ _. DATE _ <br /> Electronic Information: ❑List❑Miap—Dest:ription: <br /> FILE ADDRF-8S �N USEOkLY <br /> 9tme! <br /> street I"Tic COY UNt7 <br /> �/ 1. <br /> J031-7,-11n�1�)lTt] (?f��`Kv�►�c.� -�,� �Z.y� i\w; 06 15]. 2. unit 2 <br /> f ; <br /> El <br /> � <br /> r7. unita❑Unit6 <br /> 10. <br /> Spocific Date[tango of Wolmad cA Ru U"tad.- Flom to <br /> ENVIRONMI!NTAL RE14LTH DEPARTMENT f ILEA <br /> (]UNDERGRounn TANK(UST)D fANUP 5rIE(LOP) ❑HOUSING ABATFa1ENT C(SOUo WASTE FACILITYNEHICL[ <br /> ❑OTHER CLEANUP,-MTF(Nom.LOP) Q FOOD FACRRY U WASTE rtRE <br /> &roULRGROUND TANK(MoNITORINrJRFIuovAL) E]DOG KENNEL ❑DAIRY <br /> {-WZM2D0Us WAb fl,GENERATOR ❑CriICKEN RANCH ❑WAVEWATERTNF.ATMEuf PLANT <br /> �Tir.rreu PERM TED FACILITY ❑MOTELMOTEL ❑PUMPER TRUCK(YARotCl1EWCALTOILETS <br /> ]TATTOOISODY PIERCING ❑POOLISPA ❑ ND USE APPLICATION SITES <br /> ❑ MFOICALWASIEFACILrrY ❑(:MPLAINTRECORDS L� WHfA(PLEASESPCCIF*) Fj .11S-C S".I&''S <br /> WELL AND 15aFTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MomDAY-FRIDAY 800 AM-6:OOPM(EXCLUDING HOLIDAYS r CL, <br /> 1. List up,.)2krt sea In the space above. Sold the typete)of files from the list above by oh.o dng the appropriate Uy'4 c ri <br /> box(es). At leaf one file type MUST be selected. Fax to 4&4.0136 or it bD the ad d above. Addmus <br /> ranges will not ba accepted-for additional IteeloWnce with filo adaresses,contact the MM. Applicatiorts received dWr <br /> 1.00 pm will be procelved the next buslnoss day. <br /> Z. The EHO will notify the applicant If any EHD files exist. AmappolrrtMent for review will be confirmed approximately ten(10) <br /> days after recelpt of application. The files will bo hold for a maximum of flue businoss days for review. Appointrrimts <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EMD ruff may not be immediately available for review. A neer applicpsat rMAy be <br /> suhmitlarl whan tfie rib is available <br /> 4 Any Til^not r-atutned In the earns Condhion ae releaavd will ba reorganized by m ID staff at the expeoae of the applinaaL <br /> Fuhire Fllo rovlews by the same applicant may require a$126 deposit prior to review. <br /> I <br /> EJiq USE GNLY <br /> -- -- <br /> Received Time Aug. 9. 2012 11 :34AM No. 0786 <br />