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AUG-14-2014 THU 09:23 AM Moot wining Associates FAX N0, 5*68 7126 P. 02 <br /> 'DATE RBIT; `� f� C' - EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> 201A ENVIRONMENTAL HEALTH DEPARTMENT 11868 East Hazelton Avenue, Stockton, CA 95205-6232 qs5qO <br /> T lop }(209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> 9gjm1f1Se0vi0'AJBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: I h;';, /VIo �cLve BUSINESSiAGENCY: f"uvre -r" ;.,•, /aS.Scr:n+fi T,c. <br /> ADDRESS: 2,5 Z-7 Fres- CITY/STATE/ZIP: P-es.�v, e 9 c/37L <br /> PHONE(1): (SYY) 2643 - 70Zi PHONE(2): (57S4) 478-gSo-!( FACSIMILE: &S-s) 2C19 - 7126 <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 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ��� -" DATE S//?/�/ <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1' <br /> 1. 13.5 (�J. 1 e S+oc[c4an ICO <br /> z. Z f IIQ, <br /> ';LoZrj (,,./. Fee ry-i- S't'ree 4'2" S'IacCi.Fo,.-\ -7 Unit 7, <br /> 3. W•'2/C{S -e--o--oL Si ,L-t- s4 .k-&- 1 04" / <br /> 4 �''ry/n0 q20 <br /> 42 <br /> W . rre. ,4- Si-/•-ee+ SI-,w-k4-o e/tq .O'rinita . <br /> �"T G `� 1 A Ai J��eLl YpGLC �� g� <br /> S3v<< 1x U/r�!<�( �- <br /> 423 /✓. /v1r„�%lo.�, SF�c+.�-!1r Unit 4'. <br /> 210-0 , <br /> ❑unit 5 <br /> 10. L�'Gntt s <br /> Specific Data Range of Information Requested: From to <br /> —/ ENVIRONMENT L HEALTH DEPARTMENT FILES <br /> I��,U`�i DERGROUND TANK(UST)CLEANUPS (LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILITYNEHICLE <br /> L�������yyyyyyVTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) El FOOD FACILITY ❑pAIRY <br /> ,__,/ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL •WASTEWATER TREATMENT PLANT <br /> L1� AZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑.,/PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> �Lf TIERED PERMITTED FACILITY ❑ryPOOLISPA LJ LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING LCi COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RE pw: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uo 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 END records,please contact END at the number noted above. <br /> 3, The END will notify the applicant if any END 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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$126 deposit prior to review. *'BOXED AREA-END USE ONLY— <br /> ❑ Records provided by Staff-PPR Complete.Staff Name: <br /> F406111Jt <br /> 4126116 <br /> Received Time Aug. 14. 2014 9: 14AM No. 6831 <br />