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LXo8/27/2013 TUE 9: 46 FAX 20946 99 SJC Public Works _ _ _ 0001/001 <br /> I <br /> EHD LOG NUMBER <br /> AEaNEU SAN JOAQUIN COUNTY • <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Ga - 1868 East Hazelton Avenue, Stockton, CA'95205-6232 <br /> ephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ENVIRONMENTAL HMTH <br /> PERMIT/SFFMCES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Mark Hopkins. BUSINESS/AGENCY:San Joaquin County Public Works <br /> ADDRESS: 1810 East Hazelton Avenue CITYISTATE/ZIP:Stockton,CA 95205 <br /> PHONE(1). (209)468-3085 PHONE(2): FACSIMILE:(209)46&2999 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$12 FEE/(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3�B;USINESS DAYS <br /> SIGNATURE OF APPLICANT //' / ! ��/` DATE c�w� <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street Street Name City Unit 1 <br /> F <br /> 251 Waterloo Rd. Stockton �{ (rU 2484 Waterloo Rd. Stockton n <br /> tv' C Unit 2 <br /> 3. 2489✓' Waterloo Rd. Stockton t <br /> 4. 250 Waterloo Rd. Stockton ®unit 3 ,f <br /> 5. 2701 Wilson Wy. Stockton ''(q <br /> 6. 2901 �` Wilson Wy. .� Stocktonn unit a <br /> 7. 2802vQ, Wilson Wy. Stockton <br /> 8. 2662/ Wilson Wy. Stockton <br /> til 409'Un—It.5. <br /> 9. 3305- Wilson Wy. pj;=-,CT Stockton I&D d-J <br /> 10. 3250 Wilson Wy. Stockton <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILESpp <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) X HOUSING ABATEMENT Q SOLID WASTE FACILITYNEHICLE jd <br /> ©OTHER CLEANUP SITE(NON-LOP) ElFOOD FAciuTY ❑WASTE TIRE <br /> ©UNDERGROUND TANK(MONITORiNG/REMOVAL)DC ❑DOG KENNEL Q DAIRY �® <br /> n HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH X WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL 0 PUMPER TRUCKIYARD/CHEMICAL TOILETS . <br /> ❑TATTOOBODY PIERCING ❑POOLISPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uv to ten addresses in the space above: Select the type(s)of tiles from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Faxes(209)464-0138 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 rev(evr. 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 expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> I I J)i 'c--1367_ <br /> �j L Orsi 4� <br /> EHD ae-os bac ,ilo as-7— creel 4 ,2"7d �.c .05c� awff <br /> Received Time Aug. 27. 2013 9:37AM No. 3929 '� <br />