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-Jul 25 14 03:47p Richard Sawyer 707 996 5534 p.1 <br />I N f r I <br />:■'R-1 �P ED`r/h t Ct EHD LOG NUMBER <br />DATE RECEIVED �(� J SAN JOAQUIN COUNTY <br />ILII g rui4 i'` ENVIRONMENTAL HEALTH DEPARTMENT rWO15 <br />1868 East Haze Stockton, CA 95205-6232 <br />Hazelton Avenue, <br />ENVIHONNiENTALI-IEAgAephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orglehd <br />PERMIT/SERVICES <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: �`1ch}{il-t�� 1_ BUSINESSIAGENCY: <br />ADDRESS: � �������`i/f <br />11 Ve CITYISTATEIZIP: �1+�� ✓✓'i� y D`tl <br />� � S � <br />PHONE (1): Zq PHONE (2): FACSIMILE: 747 qqt -51 �,4 <br />��� "(� � � I <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to arrange an appointment date and time to review the requested records. <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 ��(C�,OR CHECK ONLY) - REQUEST PROCESSED IN 3 BU INS (DAYS <br />N TURF OF APPLICANT �/ Am• DATE_ <br />SIG A <br />Electronic Information: <br />❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />Street # <br />1 �6 <br />2.l <br />Street Name City=66Y* <br />// N <br />3 <br />nit <br />4. <br />5. <br />P'trnit 4 <br />6. <br />, <br />❑ Unit 5 <br />F <br />❑ Unit <br />to <br />L9. <br />10. <br />Specific Date Range of information Requested: From <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES SOLID WASTE FACILITYNE ICLE��n <br />�UNDERGROUNDTANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY ❑ Y S W' <br />HOUSING ABATEMENT ❑WASTE TIRE c� fl I'P <br />.OTHER CLEANUP SITE (NON -LOP) ❑ r <br />❑ UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY El DAIRY ANT P L T <br />❑ ABOVEGROUND TANK ❑ CHICKEN RANCH( DOG KENNEL F-1 WASTEWATER TREATMENT PLAN <br />HAZARDOUS WASTEMAZARDOUS MATERIALS ❑ MOTELIHOTEL ❑ LAND UPUMPEE APPLICATION <br />SITES TOILETS <br />❑ TIERED PERMITTED FACILITY ❑ POOLISPA ❑ <br />LAND USE APPLICATION SITES <br />❑ TATTOO/BODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (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, 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 />__,: . — ., .e .,,c,.. 0.19 riannsit prior to review. ' BOXED AREA - EHD USE ONLY— <br />Future file reviews oy the bill— opp — +y .may •• �- �- -- -- - - <br />❑ Records provided by Staff -PPR Complete. staff Name: <br />4126/14 <br />EHD 46-e6 n <br />Received Time Jul.,2.5, 2014 3' 6PM No, 6690.-- <br />