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Dec. 11. 2013 . 9: 18AM � � No. 08.18 P. 1 <br /> _. <br /> DATE RECEIVED HD LOG NUMBER <br /> SAN JOAgUIN COUNTYPVF" <br /> ENVIRONMENTAL HEALTH DEPAR i~ <br /> 1868 East Hazalton Avenue, Stockton,CA 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)464.41313 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ," r <br /> S� i3USINESS/AGENGY: • 5 „ <br /> ss: 15,E 3 B s��,��i- CITYISTATEt�IP:_�,,:�..a, . e_ �e�s yi <br /> PHQN>E(9}: (qz1x/35->;lao PHONE(2):.01 �- T•9 5 FAGSIMII.E:1-5/!�Z L& X3;4 <br /> TEN1AT/VE-APPOINTMEwr f)ATE: Timd, <br /> ' (Plans allow 10 business days from duds of epPl ea—U0 su initial-'Tant2tivo only-must be c nfirmed) <br /> " OCHECK BOX tO EXPEDITE REQUEST-$1?6 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT • . DATE 12i ia�f3 <br /> Eiectronl5 fttfoniiation, :Cl.List❑Map—Descrption: <br /> FILE ADDRESS< eNd use aNLY <br /> s strea4 s Street Name A` 4G tl p u"It Il <br /> Nd5; I• GPY[" .. 5!I(/i'-• h v !®:v•,fi'r j NV <br /> 2• it f•t? ':;�G �ats C'r t�1�r ' rJ�o�c. q 06– <br /> U It 2 ll." <br /> ^��Y,• <br /> '4e7 f Netlaf eUntt s <br /> • ;:c'-3i: :777 N•Swl'��'••'�' fvw ��1 5�'tA'�{�'T�, t�t+�(�`� a� ' <br /> •�•• ,.:ki +.= � • _dyl.�'f •Y:.i:'r ••y �.' % F., [J r a}i <br /> : <br /> it iecific late RangaVof Informatlon KequeStad: From A.1 _ to V <br /> ENVIRQNMSNTAI-HEALTH DEPARTME T PILSI� <br /> UNDERGROUND TANK(UST)CLEANUP SiTE(LOP) ❑(/IEDiCAL WASTE FACILITY SOLID WASTE FACILITY/VERICUE <br /> OTHER CLEANUP SR€(KCN•LOP) -1 HOUSING ABATEMENi WAsrETIRE <br /> UNDER'CROUNa TANK(MgNiroRING1REMOVAL)q ❑FOOD FACILITY DAIRY• <br /> AL&EOROUND TANK Q CHICKEN RANCH/Do©KENNEL WASTEwATERTREATmw PLANT <br /> HAZ7 RDOUSWASTFJHAZARDOUBMATERIAL9{� CIMOTELIHOTEL PUMPERTRUCKIYARO/C`HE�iICALTO{LET9 <br /> TtL�ED PERMuED FACILITY PODLiSPA LAND IiSEAPPLICATiON SITES <br /> i(.iT00I130DYPIERCIN0 COMPLAINTIRE6PONSERECORDS []'OTHER(PLEASE SPECIFY) . <br /> WELL AHD SEPTIC PERMIT RECOkDa'ARE AVAil-ABLEYo)i REVIEW: MONDAY.FaiPAY a:OO Am-5:00pm(EXCLUQING H6i-IpAYs) <br /> 1. 1-161 UP to tl,� sap in the Spade above. Seleot the,type(s)of foes from the list above by checking the appropriate <br /> b�xi(es):At lea9t'one file type MUST selected. Faic tp(209)484-0136 or mall to the address indicated abave.' 'Addreaa <br /> ri.j&d will not be accepted-for additional assistance with file addresses,contact the EHQ. Applications received after <br /> •:: g pun will be•proceased the next buelneas day. <br /> 2. ':-a PHA will notify the applicant if any EHD files ekIdt. An appointment for review will be confirmed approximately ten(10) <br /> .2,s after receipt of appilcdtion. The files will behold for a maximum of five business days for review: Appointments <br /> ;.quid be scheduled aurordlnaly.' <br /> 3. !,ilie'that is•actively beln `''-''"'~••eu uh°1Aff may not be immediately available for review. Anew application maybe <br /> Ebmittcd when the fila II <br /> 4, f,. 'e flip not returned In ti „� .{�� D staff at the expense of.the ap Ileant� <br /> file reviews by 1h( i v i 0+f l i ay f if flew. <br /> •.,K;c., , •1..(�ct�iYtQ 4•s tLGU J" }.3 .� .lad �•°y <br /> iri rL x'�6P S <br /> -- t � r :. 't- �..�,/l `}YI i� .s•r... :.,:•:.�v�•_i:;:•:;•.;eoY.+;�SI;•�:4]� <br /> k4S19 �q I----C+ cao occ-I'c�I2 r;�;i�:;:i•yr.,h. �."!M <br /> '�. res proyfded:Fi f' v �( <br /> 1CCU-) pq o tinca�e�f- t:•-,':• ..,;,. <br /> • .�„o`.;- fi - . ' ��- � - �t�dor ��f a - ,�,� . <br /> Received Time Dec. 11. 2C , .�. <br />