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` ' 10 LC" 'IN AUS e[06 '§ 'AIN al>,il PaAiaOa <br /> M �V V.® SAN JOAQUIN COUNTY EHD LOG NUMBtK <br /> tV`fiz�- <br /> Nw 5 2013ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Hbone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> IAMF <br /> ENVPERMITISERVlrf <br /> c PUBLIC RECORDS RELEASE APPLICATION <br /> � <br /> APPLICANT: C ) V•t r ]`F'IAA E.Z (t UQ BUSINESS/AGENCY: PQEf wer eugc ki P_P %A <br /> ADDRESS:// �- CITY/STATEOP: / <br /> PHONE (1): 9 q I ( PHONE.(2): FACSIMILE: <br /> T TATI E`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of appllcatIon submittal-*Tentative only-must be confirmed) - <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street tE Street Name City Unit <br /> 2. El4nit2 II <br /> 3. I, <br /> 4. Unit'3 <br /> S. <br /> 6. nits <br /> 6. \ ❑Units <br /> g• �• �1t�5 ��;� <br /> 61ya <br /> 10. (/ 3 ❑UnitS <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> MONDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY E]SOLID WASTE FACILrry/VEH!CLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> [UNDERGROUND TANK(MONDORINGIREMOVAL) ❑FOODFACILITY E]DAIRY <br /> a7 'ABOVEGROUND TANK . ❑CHICKEN RANCHI DOG KENNEL ERVVASTEWATER TREATMENT PLANT <br /> [21�11;IAZARDOUS WAsTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(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(2091464.0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. 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 /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the ex ense of the ayplicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. I!)E $..�.; <br /> r.:n• sl.lr.:a:u:r..r,:a;n.r,n Ima:n:a::::.:::—s• `L .: •I s:ax•?E::aiiii5?iWtll !i!IiEiil E:;! C:iS Ed yii!fJ:i �•'E t::ii;c:ri:L'cFn:n: :iE 3:IiRf?!!?!:! ... ...................si'"::�i;t•'::::^.i5 <br /> ..... .. .... , .. ., n.,._..,.__ _,..._. <br /> IEi'1' d1f'u TtERiFa;&Gi! IE!ilE!ESs:a.ad&:.nuu wua r.:a:uac._r_:::. a•t unmwmc._„ n: •:Irrzmov^a::a•mas. �'E"• t: : la. <br /> .._i_. Fi ,:..1.. ._t_i.F. .. Eanan:a :a�:.em:Rpl!ER..._.....•.x.,.. .•. E:. •^gin.: •. ... <br /> ci4ii'teilli'!ii2iC SFI .RnE'!E!.l,FSii'rfiEliq�.t__—... Islr.....:.cu: :. •.::^'n••'i ::-•a: `pr n:ia::i1y. f• ••...••...•...,•. ^ .. s T;;r•+ �i:N3�EIiF <br /> �:r r . -.•:- mlehl n u:{Imsl •:' .:_ r-aJe�NiiS' nt , e�.0 Jc.;� •5::��t1{:: IuIVLasnt�:. i.a.�7lBt7iliti.l:(I:®�IrSkicE�d!E4'y!(fi3ii{Iiiie.Hiii::•:rv�r: n ar_-•r... .•;.u.::en,.t..au..nlu. <br /> .4Ynr•,.° :....••• L�..RI c - '1 , 1 •• H a_I ..4: HIi ,: 1 : t.SfGt•1 1• ••••• ••,,•• L•• •.: <br /> ii lers,ll :• jla!{rlu'.IT,'nzpM;rt -r nmuEiiE•,^s:;.na5lijnnualr..Eialgr.�:n:as �pilt si:.a:' n',; a' :3^.-.�pklyU:�•Tu °: 7T"iiEii! : 'ii Etl <br /> _.. .._,.... �... rl ..,..._.. ........ <br /> ..:.......^_ ...r:Lu:�ar v rFiT"agar;• '. ' '1"x fcu <br /> 'rr; :r mil un:y h11t,!i:! x:xch i ir......_ca'Iriii I L'iammSrr;m ii u'ii <br /> u ixt • 'I '1 e• cnv:` ;y!n::: - C..Ik... <br /> I��I 1.g :AI?i�E . :• ;S !Llii=rSis"rWq-��•`:iBlaial°i�'iiia ::::a m:_7 ii,.1...aiT_.w.:row xa;Iln 7.It�iu.n_» r....ir�:.�...•..': :.:I •E I HU1M i:: <br /> •Y^ '• tP.: J: J.':n C<ti":5: :J 1111111 'lit 1 IIR:: !lin .I •^• 1..:: <br /> .- ..� si.., �OAW:ndTi`�•••• N�1.'.. .{I . '• !IE)�EE!!..:Yili^:n..11'::rFII:.-:�k'�[n1G��.ihillE)�^�i�li'114IIi Cn��!.F'nl1L�YM:'tIRC:1:YN :rSJg;`IIS:: <br /> EHn 98-08 <br /> 914112 <br />