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1 1 <br /> 13 <br /> 1 13 DATE EHp LOG NUMBER <br /> F "30l� SAN JOAQUIN COUNTY <br /> � <br /> �y1N a3� ENVIRONMENTAL HEALTH DEPARTMENT - <br /> �r(, 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> q1,0� hone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.arg/ehd Q <br /> 0 SN of PUBLIC RECORDS RELEASE APPLICATION <br /> LICANT: Abby Racco BUSINESS/AGENCY: siva Oak Q_eQEnviM!2mantal <br /> ADDRESS: 407 W. Oak St_ CITY/STATE/ZIP:_Qa CA 952Q <br /> PHONE(1): 20913Q9-037 __. .-�.._ PHONE(2):,j20%-365-3222 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 Wppaint mant data and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST 11h5FEE' SH OR CHECK ONI-Y)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT RATE 9-x•14 <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS EMD USE ONLY <br /> Street o Street Name City 0 Unit 1 <br /> 1. 18915 N. Hwy 99 Acampo )G� <br /> 2. 18787 N. Hwy 99 AcampO r`iley UnIt2 �G <br /> 4. (9koRe /V. R1 (al iia <br /> 5. 1(4 7-50 . 1 01 11 <br /> 6. 3-4-.50 IE- v-vBod Fa yi •` / ��//�/ ,�/.?it nit 4 <br /> 7. <br /> 8. Unit 6 <br /> 9. <br /> 10, unit 6 <br /> Specific Date Range of Information Requested: From all ayallahlp to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEMUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILI YIVEHICLE <br /> OTHER CLEANUp SITE(Nom-LOP) ❑HOUSiNG ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONIroRI11GIREmoyAL) []Foon FACILfrY ❑DAIRY <br /> ABOVEGROUND TANK [j CHICKEN RANCH/Doo KENNEL Q WAmwATER TREATMENT PLANT <br /> HAZARDOUS WAVFJ AZARDOUS MATERIALS [I MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEW-ALTO1LETs <br /> TIERED PERMITTED FACILITY ❑POOtJSPA LAND USE APPLICATION SITES <br /> TATTOO/BODY PIERCING ComPLAINTIRESPoNSE RECORDS OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERNIrr RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRJDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addressee 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)46"M 38 or mail to the addme Indicate4 gbQye 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 d any EHD Ales exist An appointment for review will be cordirmed approximately ten(10) <br /> days after receipt of application. The filea will ba held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned in the carne condition as released will be reorganized by END,staff at the expense of the appl(cant- <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. '"BOXED AREA-EHD USE ONLY'*' <br /> 0 Records provided by Staff-PPR Complete..staff Name: <br /> 4126114 <br /> r"o 4"a <br /> ReceiverTime Sep, A 2014 2:43PM No.,-7164 <br />