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DAT `��(z WED 1711SH <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> OCTNVIRONMENTAL HEALTH DEPARTMENT <br /> CA S S)' 016- 1868 East Hazelton Avenue, Stockton,CA 95205-6232 " <br /> TH Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> bq Va <br /> pu:wjl "�� �' - PUBLIC RECORDS RELEASE APPLICATION <br /> .ITS=��� _,, <br /> APPLICANT: � ,��7iI./ c�SI" BUSINESS/AGENCY: QUICK TRUCK REPAIR, INC <br /> ADDRESS: 1950 E MINER AVE CITY/STATE/ZIP: STOCKTON, CA 95205 <br /> PHONE(1): 209-547-9219 PHONE (2):-510 S j 7- If?8 9 FAX OR E-MAIL: <br /> Please allow 10 business days from date of application submittal for the records va le <br /> Staff will contact you to arrange an appointment date and time to review the req t re ds. 0 p Y <br /> CHECK BOX TO EXPEDITE RE UEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCES D NE DAYS <br /> SIGNATURE OF APPLICANT I DATE 10/19/16 <br /> 1. List up to ten addresses in the s c e ow. Select the type(s)of files from the list below 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.Applications received after 3:00 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 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 /> 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$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> -�SHEALTH DEPARTMENT FILE ADDRESSFILES EHD USE ONLY <br /> n I,UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEANUP SITE(LOP) ❑CONSUMER <br /> OTHER CLEANUP SITE(NON-LO 1950 E MINER AVE STOCKTON <br /> AZARDOUS WASTE 1 <br /> ❑DAIRY <br /> TIERED PERMITTED FACILITY Q <br /> ABOVEGROUND TANK <br /> LLL,,fj�111 UST(MONITORING/REMOVAL) ❑PWS <br /> HAZARDOUS MATERIALS 3 <br /> SPILL/RELEASE RESPONSE <br /> SOLID WASTE FACILITY/VEHICLE 4 WATER QUALITY <br /> FOOD FACILITY <br /> POOL/SPA jj4SITE MITIGATION <br /> DAIRY 5 <br /> ❑LAND USE APPLICATION SITES <br /> F-1 SEPTIC PUMPER TRUCK/ ❑HOUSING <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> E]WASTEWATER TREATMENT PLANT <br /> CUPA <br /> ❑HOUSING ABATEMENT <br /> F1 MOTEUHOTEL <br /> ❑CHICKEN RANCH/DOG KENNEL CUPA-UST <br /> ❑MEDICAL WASTE FACILITY 8 .� <br /> F-1 TATTOO/BODY PIERCING <br /> '®WASTE TIRE RSOuo WASTE <br /> 9 <br /> Y�DCOMPLAINT f� <br /> ❑-`OTHER(PLEASE SPECIFY): \/ ❑ACCOUNTING <br /> 10 <br /> —BOXED AREA-EHD USE ONLY- <br /> 0 Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br />