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02/0 12:33 503--726-5995 FEDEX OFFICE 5303 PAGE 01 <br /> DAT <br /> EGEIVE • <br /> F_HD LOG NUMt3FR <br /> SAN JOAQUIN COUNTY <br /> I■e <br /> FEB U 2 2015 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMEN TATAkgLkgne: (209) 468-3420 Fax: (209)464-0138 Web: WWW.sjgov.org/ehd <br /> PEPMiIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: LAIMIA LgCk BUSINESS/AGENCY: EBS bnSLL-I <br /> ADDRESS: LbMi SE 1fEhye, CITY/STATE/ZIP: ( k` 9 1 L <br /> PHONE(1): S - `194-'248 PHONE (2): FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange a appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE R UC$T- 1 FEE ASH OR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ,, DATE 09 --02--15 <br /> Electronic Information: [] List❑ M p-Description: <br /> FILE ADDRESS EHID USE ONLY <br /> ^"Street# fV Street Name _... .,..._�.� City Unit 1 <br /> V+/ Val Vito Ro.04�---......._— i r- UN - <br /> 2. _ i �oe <br /> S ❑Unit 2 <br /> 3. <br /> 4. -S-I� p <br /> Unit 3 <br /> 6. El Unit <br /> 7. <br /> Unit 5 <br /> 9. <br /> 110. 1 ( Unit 6 <br /> Specific Date Range of Informatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL D]WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS 0 MOTELIHOTEL ❑PUMPER TRUCKIYARDICH£MICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY 0 POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOI80DY PIERCING §Z COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: iVIONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten ggI sses in the space above. Select the type(s)of flies 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 addressindica ed above. Address <br /> ranges will not be accopted.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(1 D) <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 /> Future file reviews by the same applicant may require a$130 deposit prior to review. ***_0,QXIz0 AREA-EHD USE QNLY-* <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> Received Time Feb. 2. 2015 12: 33PM No. 8002 <br />