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I DATE Id EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY Q <br /> � ; dew D <br /> µL7�vo � a�,S ENVIRONMENTAL HEALTH DEPARTMENT <br /> kton <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> lot� hone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> LICANT: Abby Racco BUSINESS/AGENCY: �jve Q@ IOeOEnvironmental <br /> ADDRESS: 407 W. Oak St. CITYISTATEIZIP:_ QdL_QA 95 420_ <br /> PHONE (1): (209)369-0375 PHONE(2):,5209365-3222 . FACSIMILE: 369-0377 <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�pointment data and time to review the requested records. <br /> ❑CHF_CK BOX TO EXPEDITE REQUEST 1126 FEE SH OR CHECK ONLY)-REQUEST PROCESSED IN 3BUSINESS DAYS <br /> SIGNATURE OF APPLICANT PATE 9407.14 <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS END USE ONLY <br /> street ii Street Name city Unit <br /> 1. 18915 N. Hwy 99 Acampo 10 <br /> 2. 18787 N. Hwy 99 Acampo I 'tley Unit <br /> 3. <br /> 4, /V. 9� (oil/lel vas <br /> 5. IgZ91P N, l I J <br /> 6. 3-4-5 O dh-ri` k �i iii. p•Unu4 <br /> 7. <br /> S. Unit 6 <br /> 9. <br /> 10. Uelt 5 <br /> Specific Me Range of Information Requested: From all av to <br /> ENVIRONMENTAL HEALTH D PARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ©SOUR WASTE FAciu-MEHICLE <br /> OWER CLPARUP SITE(Nom-LOP) ❑HOUSINGARATEMENr ❑WASTETINE <br /> UNDERGROUNa TANK lMoNnoRINGIREMOYAL) ❑FOOD FACILITY ❑DAIRY <br /> AaOVEGROUND TANK ❑CHICKEN RANcW Due KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHA7ARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPERTRUCKIYARDICHEMICALTOILETS <br /> TIERED PERMITTED FACILITY ❑POOLISPA F7 LAND USE APPLICATION SITES <br /> TATTOOIBODY PIERCING COMPLAINTIRESPoNSE RECORns Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTic PERAt1T RECORDS ARE AVAILABLE FOR REMEw: MONDAY-FRIDAY 8:00 AM5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to Lon Addresses to the space above. Select the type(&)of files from the list above by Checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)4M413e or mail ib the address indicated above. Address <br /> ranges will not be accepted.Appilcatione 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 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 or the applicant. <br /> Future file revtows by the same applicant may require a$125 deposit prior to review. ""80XEP AREA-EHD USE ONLY"' <br /> ❑ Records provided by Staff-PPR CDmptete,Staff Name: <br /> END deAe �f28nd <br /> Received, Time Sep, 29, 2014 2:43PM No. 1164 <br />