Laserfiche WebLink
rm■ c 11 12 06:01p Lee & Fierce, Inc. <br />ii` ATEP-2CEt11 D SAN JOAQUIN COUNTY <br />r� 'V ENVIRONMENTAL HEALTH DEPARTMENT <br />• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />lephone. (209) 468-3420 Fax: k209),464 -0-I68 Web: www.sJgov.orgtehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />N.i <br />I�Nljx�R X115'` �1• - t <br />APPLIC�Q: jD1^ 1�8-� eBUSINESSIAGENCY: Le1e'--�t�y\[ <br />ADDRESS: `3 -9 S, Us -t - 4c Ave-, s -,t1e /41 CITYISTATE/ZIP: (� I�Ur J1P— 0- <br />PHONE (1): 2.0 � `126 6;L76 PHONE (2): ' �1 c*-) 5 12 FACSIMILE: 2e i j 6 �7q <br />TENTATIVE` APPOINTMENT DATE: 45,&�{> —Time: <br />(Please allow 10 business days from date of application submittal -"Tentative only- must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 FE (CAS SH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BU5 ES DAYS <br />SIGNATURE OF APPLICANT llY-�-r DATE RZ 1 i z— <br />Electronic Information: ❑ List ❑ Map—Description: <br />Street # <br />FILE ADDRESS <br />Street Name <br />City <br />EHD USE ONLY <br />❑ Unit 1 <br />Ej Unit 2 <br />2- <br />I T33 -2- <br />3. <br />4. <br />i <br />�l `5L <br />-1 `1 <br />LrG- ��`rLo <br />l,l�t�f� <br />(-CiAr`--Op <br />� Unit 3 <br />fin <br />5. <br />'U�� <br />IL-1Unit <br />6. <br />�� (� <br />7. <br />„FLS <br />��� b <br />rL/�` <br />1.��` <br />it -77 <br />❑ Unit 5 <br />9. <br />To view the HMMP <br />(Hazardous (p Unit 6 <br />10. <br />Specific Date Range of Information Requested: From Materials Management Plan) go to the <br />ENVIRONMENTAL HEALTH DEPT following website: www.sjoesdata.org <br />JAE <br />NDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FAC :HICLE <br />THER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT P / ���" <br />NDERGROUND TANK (MONITORINGIREMDVAL)� ❑ FOOD FACILITY DAIRYOVEGROUNOTANK C>L ❑ CHICKEN RANCHIDOG KENNEL �(ASTEWATERTREATMENT PLANTAZARDOUS WASTEIHAZARDOUS MATERIALSo/— ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICALTOILETs <br />IERED PERMITTED FACILITY D( OOUSPA ❑ LAND USE APPLICATION SITES <br />ATTODIBODY PIERCING COMPLAINTIRESPONSE 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 EFID. 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 confinned 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 pit the expense of the applicant. <br />Future file reviews by the same applicant may require a $125 deposit prior to review. ""'BOXED AREA- EHD USIY ONLY <br />gongMf <br />�- <br />Received Time Dec. 11. 20 5:O M No. 1835 <br />0 <br />