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Al'�'12014 15:04 FAX 559 442 5 KLEINFELDER I?J001/001 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> EC'ENE ENVIRONMENTAL HEALTH DEPARTMENT <br /> ° 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> FEB ] 8 .201Q Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd q ' <br /> _....r,,Tal 1-IeWe PUBLIC RECORDS RELEASE APPLICATION ' <br /> E pnr�IT'eEt�V n Q t� ^^ // <br /> AFPNANT: ! !�=/ lVe 00 A c1 BUSINESSIAGENCY: C.4;1 :ce Id ei'L <br /> ADDRESS: cJ l 2 N CTc>—F TP. 16 C, CITY/STATEIZIP:_E& - S/✓D V722-- <br /> PHONE (1): �Q- 77'�y rJ`� PHONE(2): 5 - ( 47-?.��2 FACSIMILE:Ste, 442 -561 <br /> TENTATIVE`APPOINTMENT D&7E: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only.must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-S125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street# , Street Name City El Unit 1 <br /> 1. L.f�►[�' a e2 vd � �'1�. � 5�m� fi <br /> 2. L " [„ l I•I [I Unit 2 <br /> 3- 14 (a 0a+g/% U lx� 1 +r <br /> K Oj�,`I/ fa .r�nit3 <br /> 6. 351/`- 2R0 kee, A I " 2`�..h Illi 21�, i 0olnl14 <br /> Glatv,� —n r 3�istLs <br /> g- 4369 tr k � ti (,� {� (-DA) C( ❑Units <br /> 110. 1 Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILTTYNEHICLE <br /> OVER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> 'AB[f]Q ERGROUND TANK(MONR '❑ORINGIREMOVAL) FoDD FACILITY ❑DAIRY <br /> � �VEGROUND TANK' [3 CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> :Z) AZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑CDMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files 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 /> daysafter receipt of application. The tiles will be held fora 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 a plicanL <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. s '�&? <. ' ,_.:..- <br /> .vl <br /> l`=t <br /> :._... ..:dc.v.,...;.;vr.:is"g..:•;'a r..a 1=iiei�.f:.a? <br /> ... .:.: ...._..,:,.:.xiF'n'iS=3E._c:�ii"vr <br /> .. .. ... ..- _... _ .:;..;, .; . .. .... .....:::..•°_ice' <br /> ..�L2PIE�d-f#•'�3[isp;(-f.�...5�,.... � � .. ...._ ....�.. ......:::.::::.a:::cx�.rxi. 9/M72 <br /> EHe 14-06 <br /> Received Time Feb. 17. 2014 2:53PM No. 5217 <br />