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May, 27, 2015 12: lOPM0 • EHD LOG NUMBER <br /> No. 1506 <br /> DAI�ncn�,civcu SAN JOAQUIN COUNTY <br /> �EV��U�� ENVIRONMENTAL HEALTH DEPARTMENT U <br /> MAY 2 7 2015 1868 East Hazelton Avenue, Stockton, CA 95205-62321 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAI_112LTH Pu <br /> oGRnnr•/ecntnC�RBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ashlen McGinnis BUSINESS/AGENCY: San Joaquin County Pubic Works <br /> ADDRESS: 1810 E. Hazelton Avenue CITYISTATE/ZIP: Stockton CA 95205 <br /> PHONE (1): — ( 09) 468-3085 PHONE(2): FACSIMILE: 09) 468-2999 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$130 FE (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT adA DATE `JIZ� IS <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City ,V Unif1 <br /> usawwwfo 151M <br /> 2 D Q �Lv tiFl= Unit 2 <br /> 3. 9(D" V RM lKynnivo, ti <br /> 4. g(p(v50 N S'Gs-Gl'44WY>'►'y 6'W4 'thpyv)1rn tiFt <br /> Unit 3 <br /> 517 N SGtPrt'Gl M PiYi1U �(I�d ���rnfi> ST i SITE MITIGATION <br /> 6. ZI'Unit 4 <br /> 7. Room P(e.5 <br /> )'Units <br /> 9. <br /> 'Ell <br /> Unit s <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY SOLID WASTE FACILTTYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ®HOUSING ABATEMENT WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) FOOD FACILITY DAIRY <br /> ®ABOVEGROUND TANK CHICKEN RANCH/DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> El HAZARDOUS WASTEMAZARDOUS MATERIALS MOTELIHOTEL ®PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY POOUSPA LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAU-ABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> i. 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(205)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. 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 /> 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$126 deposit prior to review. "*BOXED AREA-EHD USE ONLY' <br /> Receeived Time May. 27. 12015=12:07Faff ,'8S31SM11 Name: <br /> UH04a-09 <br /> 5H 1115 <br />