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I. DATF,R, F) Y\�'` FHO LOG NUMBER <br /> ■■ 5�11rs ; SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> " <br /> &1-51 1868 East Hazelton Avenue, Stockton, CA 95205-62.32 <br /> hone: (209)468-3420 Fax: (209)4640138 Web: wwvv.sjgov.org/ehd <br /> T <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 0LIC, <br /> ANT: Abby Racco BUSINESS/AGENCY: jve k eoEnvir�nm� l- <br /> ADDRESS: 497 W. Oak St. CITY/STATEIZIP:�j MCA 952p <br /> PHONE (1): X20 )369-037 _ w - PHONE(2):.J209�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 nrointment data and time to review the requested records. <br /> ❑ <br /> CHECK BOX TO EXPEDITE E QUEST 1'5 FEE SH OR CHECK OM-Y)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 9-;!—, <br /> Electronic Informat(en: ❑List❑Map–Descriptlon: <br /> FILE ADDRESS EHO USE ONLY <br /> Street# Street Name fifty Unit 1 <br /> 18915 N. Hwy 99 ACalnpo i Lo <br /> F2. 18787 N. Hwy 99 Acampo r'tt Un(t2 2 <br /> 3. <br /> IV. <br /> -'u it3 <br /> s. Iq 7.S-4P . l 1 °I <br /> 6, 3-�--5`a �, v�eod Fv-�� •� ��';1�Z G% L ❑Unit 4 <br /> 7. <br /> g. El Untt 6 <br /> 9. <br /> 10. unit 6 <br /> Specific Date Range of Information Requestod; From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLFAmup$Ts(LOP) D MEDICAL WASTE FACILITY SOUO WASTE FAC MIVEHICLE <br /> OTHER Ct FatiLIP SITE(NON-LOP) L]HousiNa ABATEMENT ❑WAM TIRE <br /> DAIRY <br /> UNDFRGROUND TANK(MoN(roR1NGIRFmoyAL) D�--7J FooD FACiLrry ❑ <br /> ABOVECROUND TANK LCHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS D MOTELIHOTEL ❑PUMPERTRUCKIYAROICHEMICALTOILETS <br /> TIERED PERMITTED FACILITY POOLISPA LAND UsE APPLicAnoN STri_s <br /> TATT00fS00Y PIERCING COMPLAINTIRESPONSE RE.COROB I]OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8.00 Ala-5:00PM(F-XCLUDING HOLIDAYS) <br /> 1- L let uo to ten addressa$th 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(las)484-0 3$or mail to the address Indicated gkpove. Address <br /> ranges will not be accepted.Appllcatlonp na—ivad after 3:00 pm will be processed the next business day. <br /> 2. FOr assistance In identifying.the nature and content of FHD records,please contact END at the number noted above. <br /> 3. The FHD will notify the applicant if any EHD files.exist. An appointment for review will be confirmed approximately ten(10) <br /> days atter receipt of application. The files will be held for a maximum of five busines-s days for revi*w. ,Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be reorganh:0 by END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ''*`$f AFD AREA m AHD USF 4Nl_Y"' <br /> 0 Records provided by Stafif->'PR Complete.. swfr Name: — <br /> 412811 d <br /> END A"G <br /> Received Time Sep, 29. 2014 2,43PM Po, 7164 <br />