Laserfiche WebLink
Sent By: ORSWELL & KASMAN, INC. ; 626 932 1807; Dec -15-09 9:40AM; Page 111 <br />EHD LOG WADE <br />RE=FD SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />uLL 1 5 2009 600 East Main St. Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/eh <br />ENVIRONMENThAI/QVlPCC!HEALTH PUBLIC RECORDS RELEASE APPLICATION <br />DI`RneiT/c�Q�►Ir�� <br />,APPLICANT: " I `Y GZ I�-0 w S� t` _- BUSINESS/AGENCY: <br />ADDRESS'316 <br />w Ba C\* CITY/STATE/ZIP: v,' CA q 101 <br />PHONE (1): ZOO PHON (2)- � FACSIMILE: <br />TENTATIVE*APPOINTMENT DATE: Time: <br />(Pleaso allow 10 business days fro to of applications mittal - •Tenfat(ve only - must be confirmed) <br />CHECK BOX TO EXPEDITE REQUES l - $115 FEE (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSIN SS DAYS <br />SIGNATURE OF APPLICANT DATE—-) <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS EHD USE ONLY <br />Street # Street Name City Unit 1 <br />1. �JoZ 5 } fl�e5t C r cY Way �oc fC a r 0e 5 y <br />_ / <br />2. a L4 ` f5 W a <br />aY oc V�0.r_ fP _ Unit z <br />_.. <br />4. �.� C9yY� S�vCk '1......... e S. �11 Unit 3 <br />5. 1651 Y y ..._ G _.. ak N0 b 1 /U,) w/� i <br />6. t ,• _ nll4 <br />_...... ...... WWW <br />g C.l unit s <br />- <br />❑ Unit 6 <br />Specific Oato Range of Information Requested: From <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES1 <br />E] SOLID WASTE FACILITYNE111CLC <br />3; <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON -LOP) <br />❑ HUUSING ABATEMENT <br />❑ Fouu FACILITY <br />I ( <br />❑ WASTE TIRE t <br />[b(„%�'� <br />UNDERGROUND TANK (MONITORINGIRF,MOVAL) <br />L1 Dor, KENNEL <br />RANCIi <br />❑ DAIRY <br />El WASTEWATER TREATMENT PLANT C� <br />HAZARDOUS WASTE GENERATOR <br />C ] CHICKEN <br />IERED PERMITTED FACILITY <br />MOTELIHOTEL <br />❑ PUMPER TRUCKNARD/CHEMICAL TOILETS <br />TATTOolBODY PIERCING <br />❑ POOLISPA <br />❑ LAND USE APPLICATION SITES <br />❑ MEDICAL. WASTE FACILITY <br />❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY S:OO 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 ;_id dress indloated 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 of five business days for review. Appointments <br />should be scheduled accordingly. <br />3. A file that is actively being worked on by END staff may not be Immediately available for review. A now application may be <br />submitted when the file is available. <br />4. Any rile 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 $115 deposit prior to review. <br />5. If you need further assistance, please contact Diane Martinez, at (209) 468.3425. <br />EHD USE ONLY <br />♦ � � -r fI/I.1/J17� '�/L/aft+ <br />_48-0i 8427/09 <br />