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From:Amy Kerstiens Fax +1 f877)623-5499 t. Fax: +1 1209)4640138 -age 2 of 2 3/2812012 10:01 <br /> DATE RECEIVED - SAN JOAQUIN COUNTY '�'' EHD LOG Ni <br /> RECEIVED ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 1 w <br /> fdl t 2 S 2��2 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgc)v.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> _ <br /> APPLICANT: Amy Kerstiens BUSINESS/AGENCY:Em,im Assess <br /> ADDRESS: PoBox1154 CITY/STATE/ZIP:Bonners Ferry,ID 83805 <br /> PHONE(1): 077-629-6838 PHONE(2):208-946-4195 FACSIMILE:877-623-5493 <br /> TENTAT/VE+APPOINTMENT DATE: Apni 9,2012 Time 9:00am <br /> (Please allow 10 business days from date of application submittal.-Tentative only-must be confirmed) <br /> QHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIG/NATURE OF APPLICANT Amy Kerstiens DATE March 2e,2012 <br /> Electronic Information: 0 List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1 1. 678 N. Wilson Way Stockton lj�( 1 I�1 1 S t' 0Unit 2 <br /> f <br /> 2. <br /> �f✓-_ 3. 7C� <br /> 4' Haig UL11y 4 Unit 3 <br /> 5. <br /> 6. unit 4 A <br /> 7. <br /> 8. <br /> C]Unit s <br /> 9. <br /> 10. <br /> El Unit <br /> Specific Date Range of Information Requested: From 1940 to present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑� UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACiLTYNEHICLE <br /> ❑� OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY EI WASTE TIRE ffVV <br /> Q UNDERGROUND TANK(MONITORING REMOVAL)d El DOG KENNEL ❑DAIRY Lk,I�/zz,, <br /> • i/ <br /> ❑� HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT -7 <br /> El TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMCAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑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 AMS:OOPM (EXCLUDING HOLIDAYS) <br /> 1. List uo 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(2091464-0138 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 flies will be held for a maxim um 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 /> - 6 R, <br /> Hb 4&O6 Z <br /> I Jill <br /> �j-z-Iz= �0©41e�• ­x2Ir a Will of <br />