Laserfiche WebLink
HrVIU/LUI0/SUN 1L. U5 rm 1A.k IN 0. Y. UU'2/UTI <br />TT EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />,APR1 1 � 6 ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />eIe hone: 209 468-3420 Fax, <br />209 464-0138 Web. wwv,r.sjgov.org/ehd <br />PEPWITISERMCES <br />PUBLIC RECORDS PELEASE APPLICATION <br />APPLICANT: iJ0r)tq OnjaeLl BUSINESS/AGENCY: WxAl arc, l,'Ukl s Assoc _ <br />ADDRESS: �05D Zh�US�iQI ?1u1 CITY/STATE/ZIP: V4es1 SSC, Cla �7571�1 <br />PHONE (1): ?ju-_'7a - I mo}? l PHONE (2): FACSIMILE: <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from data of application submittal-'Tenfsflve only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE q 111 11 4 <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />END USE ONLY <br />1 <br />Street# <br />Street Name <br />CitynUnit <br />1 <br />'1555 <br />'RCcU4i"U <br />/C -o <br />Q"Unit2 <br />2./'-103 <br />I��c{4 R.rc <br />kb� <br />N" <br />Unit 3 <br />1511 <br />Pc.r l 1, c: fit. <br />�Icv( )c (ate <br />5. <br />r <br />71 Unit 4 <br />Unit 5 <br />0 <br />�. <br />sign <br />Specific Data Range of Information Requested; From 3' ,A to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />[UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY r17 SOLID WASTE FACILITY/VEHICLE <br />ROTHER CLEANUP SITE (NON -LOP) n HOUSING ABATEMENT WASTE TIRE <br />UNDERGROUND TANK (MONITORINGIREmoVAL) FOOD FACILITY ❑ DAIRY <br />RABOVEGROUND TANK CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br />HAZARDOUS WASTEIHAZARDOVS MATERIALS ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />❑ TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOO/BODY PIERCING ❑ COMPLAINT/RESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY B:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses in the space above. Select the typa(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (2 0) 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 offive 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. BOXED "AREA;=:;HD..USI_ ONLY <br />LUT11 <br />❑ R60ordS:provided:byStaff-PPR.Coenplete:,Staff Narrie:, <br />EHD 48 -OG / 1/4112 <br />Received Time Apr,11. 2016 12:06PM No.0684 <br />;9't'�joi•, <br />