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1 008/27/2013 TUE 9: 46 FAX 2094582999 SJC Public Works 2001/001 <br /> ■ <br /> ■ `r <br /> l� EHD LOG NUMBER <br /> AeMIVED <br /> SAN .IOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AUG Z 7 �� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> e'Tephone: (209) 468-3420 Fax: (209) 464-0138 Web: wv,/w.sjgov.org/ehd <br /> ENVIRONMENTkL REALTH <br /> PERMITISERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Mark Hopkins BUSINESS/AGENCY:San Joaquin County Public Works <br /> ADDRESS: 1810 East Hazelton Avenue CITY/STATE/ZIP:Stockton, CA 95205 <br /> PHONE (1): (209)468-3085 PHONE (2): FACSIMILE:(209)468-2999 <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 REQUES $12 �FEE(CASH O CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT /f�,, DATE / //. -3 <br /> Electronic Information: F71 ist❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city Unit 1 <br /> 1. 2512 Waterloo Rd. Stockton <br /> 2. 2484 Waterloo Rd. StocktonQ unit 2 <br /> 3. 2489 hry Waterloo Rd. Stockton <br /> 4. 2503 Waterloo Rd. Stockton ,,! � <br /> `� �-� u Unit 3 <br /> 5. 2701 Wilson Wy. 3<;2-6 Stockton a Cwt ��� 0� <br /> 6. 2901 YWilson Wy. Stockton { Unit 4 <br /> 7. 2802 Wilson Wy. Stockton <br /> L88- 2662 Wilson Wy. 3S� Stockton ;flUn;t s <br /> 3305 �1� Wilson Wy. Stockton <br /> 3250 Wilson Wy. Stockton (]unit s <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑■ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 9 HOUSING ABATEMENT 9 SOLID WASTE FACILITYIVEHICLE <br /> ©OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ©UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL Q DAIRY <br /> Q HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH <br /> WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTELIHOTEL Q PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA I_]■ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 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 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 (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 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 expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> E4D USE ONLY <br /> EHD 48-05 <br /> 811/11 <br /> Received Time Aug. 27, 2013 9: 37AM N0. 3929 <br />