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'111" Oar. 14 2014 8 : 2GAM THFUPS STORE 2503 8I, 7251772 p . 1 <br /> ■ <br /> l� <br /> l ■ � EHp LO(3 NUMBER <br /> 1 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT � a <br /> OCT ! 2014 1868 East Hazelton Avenue, Stockton, CA 95205-8232 <br /> Telephone: (208) 488=3420 Fax: (209) 484 0138 Web : www.sjgov, org/and <br /> InHUtVI1flUTALHALYE4 PUBLIC RECORDS RELEASE APPLICATION <br /> r <br /> APPLICANT: + 1 G BUSINESS/AGENCY: ty <br /> ADDRESS: t, CfTY/3TATEmn. t I <br /> PHONE (11 ): �9t (, ��ry7 — ? G PHONE (2): FACSIMILE: ! 'a.0 ;a hoz , <br /> TENT/4TIVE` ArP01NTME:N DATE: Time: <br /> (Please allow 10 business days from u of appll on eubmitlal -*TenbNvs only - mist be eon <br /> ❑ CHECK BOX TO EXPEDITE REQUEST - f125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic information : F.1 Llat ❑ Map — Descrkdoan: <br /> FILE ADDRESS EHOUSIZONLY <br /> street R strsat Name CRY Uxxlt 1 <br /> 2• S �1 .� UsJa a +•t) �� t t }= ley ihdtz 1 �� <br /> 3. 1 �" <br /> 4. nbr'� a tie <br /> e. <br /> g r0 !� / urHt ♦ <br /> 3 <br /> 9m7 unit <br /> 10. units <br /> Spocillc Date Range otlnform"an Peclueatvd: Frani to <br /> ENVIRONMENTAL HEALTH DEPA EMT M[LeS <br /> NmROmmTAW (UST)Cizmup817E (LOP) IIEDICALWAIREF xrdtt El $mm WAS(EFAcLmNEN <br /> OTHERCLEWJPSITE (NoNoLOP) 1i0USWAIXATEd ' fr ❑ WAmTerm <br /> _ tmERtaRoule�TAttK (MONrrORw.4R1yANAL) h� 72AC" v MIRY <br /> VEOROUNDTANx ] C� � a (•?� -ri J C � It L 1D WAwmTERTREATREw PLAw <br /> 9 WAUERA7ARDOUS MATERX8 [� C^6`Tto�^-du< 5L ® PUMPER TRUCKIYARDICHEIOCALTotLEf6 <br /> TEREi1 PERMITTED FAC11F FaaLMPA ® LAND UaEAPPUCATION SITES <br /> DTATToD160DYPiEicING 4;tJ iRN ElOTHER (PLEASESPE nj <br /> WE:LLAND SEPTIC PERMIT REcoRDs ARE AVXI LEFORREMWb Mf l�7d' 31�AY 5 .00 AFt"3�:0(DRIN (EXCLt1DINp t LlfrAv$) <br /> 1 . (.lt:S ua �q ad res�csy In ilia• spares sbovo. select the typo(e) of flies 5uu eu the list above by c:hocking the apiampriato <br /> box(aa). At least one file type MUST be esbctad Eaxto t 484 et98 a melt fn the addMPR {r dlested above- Address <br /> ranges will not be accepted - for add ltloml assistance wtM file addrwse®, contact the EHD. A�aislloetlonF raCBtv¢d after <br /> 3100 pm will be processed the next business day. <br /> 2. Tho EHDw ill notify the applicant If any EHD tike exist An appoin[mvrrt for review Wit be confirmed approxlmidoly ton 00) <br /> days after receipt of application. The flies wHl be haid for a maximum of fire business days for revisor. Appoinbrearda <br /> should be schedule! accordInpty, , <br /> a. A Me that is actively barn® worked on by EHD staff may not be lmmadiately available for review. A new appticaflon may he <br /> submltW when the file Is available. <br /> 4. Any fila not returned in the same condition as released will be reoWnired by Ef D staff at the. expense of the applicant <br /> Future flls reviews by the same appitcant may require ■ $125 depaelt prior to review. 4 ?91 1? 13l;U <br /> , .. , <br /> IF IF <br /> IF F XI FF <br /> x —. . <br /> , . . <br /> , ,. <br /> ,. : : . . . . . s: ., •. <br /> . ... 1. 111.: <br /> :: <br /> ;,, , . <br /> ..,i . : : .. ; . r <br /> . ., : . : .. , ..a:. . . - - III <br /> - <br /> : . . . <br /> .. . 1.. , ...1. . , .. , 11 :., :., <br /> ::, , .. � ..•. .:>. .;:. ..:,. , .,11. ,1, .1 <br /> Ardsail►I: ky„1�ta17»RPI ::Gath �li�tea:stinr' I Fa <br /> f�atrt : <br /> Received Time Oct . 14, 2014 9 : 34AM No . 7324 <br />