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FroM:MarCus Bole & Associates ! 11 11 /- 12013 16-21 3014 P.001 <br /> Ca " r <br /> ` ICC *1113,NUMBE,�'V G SAN JOAQUIN COUNTY �(/t <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> NOV 18 2013 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> EWRON ENTALI HEALTH <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: h{}VIO �pLL. NTALH LTFY <br /> BUSINESS/AGENCY; gtJGt`RE1<�,TVj- <br /> ADDRESS: _ I q �/ ej..ock p� CITY/STATE/ZIP: W12y�4rzAv6, cat- <br /> PHONE(1): _�jp-�!/S-(���3 PHONE (2): FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: II —dl Time: 11 <br /> (Please allow 10 business days from date of application submittal-•Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUE$ _$125 (CA O CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ///y/pJ��1// DATE 111/f�/�_j <br /> Electronic information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City <br /> 1• !S ❑Unit 1 <br /> E ce SfacT N l�lQ `c✓/� a <br /> 2 /S3 &Z St to iaGk Illi✓ /l'� GtS'lvG�c�l ❑unitz 1y <br /> 3. 0 S, w I f 50 ✓ p. <br /> 4. D E MA N sr 2 j 5� GO SPCC FVAI 2 n�� Cyreo,✓6� J / <br /> 6' 0 �3�AD�/lo �Inff G OL� ✓fw /, /? ❑unit3 <br /> 6 11 A <br /> - <br /> �: �I Zr /3 <br /> � 0 Unit <br /> 8. <br /> 9. <br /> r r.: ❑Units <br /> 10. <br /> — i Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) [_1MEDICAL WASTE FACILITY SOLID WASTE FAciuryNEHICLE <br /> HER CLEANUP SITE(NON-LOP) ElHOUSING ABATEMENT WASTE TIRE <br /> 1VPUNDERGROUND TANK(MONITORING/REMOVAL) ElFOOD FACILITY [IDAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> 6LgAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL <br /> RED PERMITTED FACILITY ❑PUMPER TRUCK/CATION SITES 71OILETS <br /> ❑POOUSPA - ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING OMPLAINTIRESPONSE RECORDS - <br /> ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM (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 theapplicantif 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. B XED <br /> _b EA4 E}l�, S gISM <br /> -_ ......._ S <br /> a - <br /> t7 Recflrcls_prpu��ied by Staff PPR Complete,staff Name. <br /> EHD 48-06 <br /> D/6/12 <br /> Received Time Nov. 17. 2013 5: 19PM No, 4549 <br />