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Ijb 181412:46p � 1 _ _, ry p ' 1 <br /> f F : b . 18 . 2014 1t : 24AM San Joaquin County N °• 5218 P. 1 <br /> � �o^�' EHDLOG NUMBER <br /> ■ DATERE NEI) SAN JOAQUIN COUNTY <br /> zm U <br /> 201A ENVIRONMENTAL. HEALTH DEPARTMENT ��j <br /> FEB .[ g 1Bea East Hazelton Avenue, Stockton, GA 95205-6232 q'�40, <br /> l <br /> Telephon 4 09) 468.3420 Fax: (208) 46d-0138 Web: wwWsjgov,orglehd <br /> ,it SE"" BLIC RECORDS RELEASE APPLICATION m <br /> EI4 <br /> d� <br /> APPLICANT: N\ s s ` � a s - ^ { r -0r--gUSiNESS/AGENCY: 1� u <br /> AppRFS5: r' r J CITYISTATEIZIP: G�C7 <br /> PHONE {1): �v`1 531 D pHDNE FACS)111111 � <br /> TENT TWE` APPOINT.MENTDATE: ea , � : 1 i Time: / d /-I Il <br /> :? tPlesse ellowato business days from data of ap - cation submittal -'7ellmuye Daly • mustba eehFrmed) <br /> Islab 3 ES <br /> HECK SOXTO EXPEDITE REQUE - $125 (CASH 0 LY) - QUEST PROCESSED IN 3 eu IN'�I /� DAYS <br /> NI <br /> SIGNATURE OFAPPLIGANT DATE v`L o�o / <br /> Elactranic Information: [1 List ❑ Map . Description: <br /> i:ILE ADDRESS eHo usEON1 Y <br /> Slree[ tI Street Name city Unit1 <br /> 1 , a 03 � v � <br /> ' ❑ UnlE2 •' <br /> • / / <br /> 2 . <br /> . O ; �L7 . _i f),r. }, ;/ ci1'7. 71 <br /> 3 <br /> 1It3o <br /> L _ <br /> 1 Ll <br /> 6. • <br /> l I _�nh4 <br /> Epp <br /> EC.- 1tWtf:vA <br /> B. ( LcVPIi , C t J!:' I--,__I <br /> � ❑ unit s <br /> 10. Cl Unit a <br /> Specific Data Range of Information Requested: Fromt° <br /> ENVIRaNMENTAL HEALTH DEPARTMENT FILES <br /> 01� DERGROUNDTARK (UST) CLEANUP SITE (LOPI ❑ MEOICALWASTEFACLITY ❑ SOLID WASTE FACILnTNEtitCLE <br /> — 0HEHWC EAKUP_SITF--(NOR-LDP)- - - - - ❑ HOUSIHO ABATEMENT r❑-�-W� A5fETIRE <br /> UHDEROROUND TANK EMONITOmNO/REMOVAL OO PACTLI UvA7R <br /> ❑ AOOVEGROUND TANK ❑ CHICKEN RANI IDOo KENNEL ❑ WA5rEWATEKTREATMENT PLANT <br /> HAtAN00IWASTE[KVAR000SMATERIALS ❑ MOTELIHOTEL ❑ PUMPERTRUCKIYARDICHEMICALTO)LETS <br /> G TMRED PERMITTED FACILITY ❑ PoOUSPA ❑ LAND USE APPLICATION SRES <br /> ❑ TATTOOIPOPYPIERCING ❑ COMPLAMTIRESPONSE RECORO$ ❑ OTHER [PLEASE SPECIFY) <br /> 'VI LLANOSEPTIo PERMITRECORDSAREAYAILAOLEFORRevIEWI MONDAY-FainAYR:OD AM-S:OOPIN (EXCLUOING HOLIDAYS) <br /> 1 . List uu to !en addresses in the space above. SslecE the type{s) of fllee from the Ilstahave by checking the appropriate <br /> trax{es). At leastorre fila type MU5T beselecled. Fax to (209) 46d-0138 ormell lfl tfie address Indicated above. Address <br /> ranges rvitl not be accepted - foradditional assistance with rile addresses, contact The EHD. Applications n:eelved after <br /> 3:110 pm wi0 be processed the next 'busineas day. <br /> 2, The EHD will notify The applicant If any EHD files exist. An aPpoinfinent for review wiN ba confirmed approximately ten (10) <br /> days aifor rscaiplof applleaHon. The files will be held fora maximum of five business days for review. Appointments <br /> — -shautd be scbedutedaccordtnHt <br /> 3. A rile That is actively being worked °n by END staff may not be immediately available for review. Anew application may be <br /> submitted when the file is Wellsat <br /> 4, Any Me not returned in the same candittan as released will be reorganized by EHD stall atthe ex enEpp <br /> ae of the ficant. <br /> Fu lure file reviews bylherental applica ntinayrequire a $125deposit prior toreview. E,fitBRE ARBAw: H . _ <br /> le'. WE WE <br /> WE j WE <br /> EE E <br /> < ... <br /> . . c . ,. : <br /> `EISReco ds1?r"ovfde:d; [iVStaff-P_PRLCornpfete:istafr Narie;= <br /> WE <br /> Y . . . . . • •. . : . : W . ., < <br /> Received Time Feb . 18, 2014 11 : 31AM No . 5220 <br />