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jiit301302:1Op Nelson . 209go , P•1 <br /> is EHD LOG NUMBER <br /> °FIEI NEE SAN IOAQUIN OUNTY <br /> 1n <br /> ENVIRONMENTAL HEAL H DEPARTMENT �� <br /> OCT 3 0 2013 1868 East Hazelton Avenu , Stockton, CA 95205 6232 <br /> Telephone: (209) 468-3420 Fax: (209)46 -0138 Web: www.sjgov.org/ehd <br /> (00 <br /> �pEORNMM SERVIC LTH <br /> PUBLIC RECORDS RELE SE APPLICATION <br /> APPLICANT: Mike Nelson B SINESS/AGENCY: Nelson Environmental <br /> ADDRESS: 103 Laurel Ave . CITYISTATEIZIP: Atwater, CA 95301 <br /> PHONE(1)- 209-769-7460 PHONE(2): FACSIMILE:775-254-3748 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application sr bmittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE RE T-$ 5 FEE{ H R CHE ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE D <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name ity ❑ Unit <br /> [44. <br /> 3655 E- Cherokee Rd. Stoc ton )� <br /> Ceotrac er shows this address as a La d , Units <br /> Disposa Site and show it as an pen ase but <br /> with no ther information listed Jus ❑unit 3 <br /> $ wonderi g if you have any thing 'n yo r file <br /> 6. about this- Listed as Delta Tru k Sal s. 11 7 13 Unita <br /> 7. � � ✓�ti/6�l� <br /> ❑Unif 5 <br /> 9. <br /> 10. <br /> Specific Gate Range of information Requested: From <br /> to / <br /> ENVIRONMENTAL HEALTH Di PARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEM NT ®SOLID WASTE FACILITYIVEHICLE <br /> BOTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MDNnoRINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD(CHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑PDOIISPA [3 LANO USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑COMPLAINT RECO IDS <br /> ❑OTHER(PLEASESPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: ONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up totem 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. Faxto 209 4 -0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file ad resses,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 appoi tment for review wil I be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held fora maxi um 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 im ediately 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 reo ganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$125 dep sit prior to review. <br /> Received Tine Oct- 30. 2013 2, 12PM No. 4401 a„n, <br />