Laserfiche WebLink
T � <br />RrtTTE© SAN JOAQUIN COUNTY 0 EHC7 LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT 7S' <br />SEP 0 $ 2008 600 East Main Street, Stockton, CA 95202-3029 <br />Telephone; (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.or /e <br />ENVIRONMQNRHEALTH <br />viCES PUBLIC RECORDS RELEASE, APPLICA N <br />N <br />ADDRESS: 902 Industrial Way Cltylstete2lp Lodi, CA 95240 <br />PHONE (¶: 209-367-3701 PHONE (2): FACSIMILE: 2(lq-°69-4228 <br />TENTATIVE" APPOINTMENT DATE: q —. S— -0 -K- Time: <br />1PIAR90 allow 10 business days from date of application submittal -'Tentative only - must be confirmed) <br />CHECK BOX TO EXPFDITH REQUCES�T $106 FE ASH OR CHECK ONLY) - REQUEST PROCESSED IN 9 BUSINESS DAYS <br />SIGNATURE OF APPLICANT % Ilr/UC DATE 7 -5 -o? - <br />Electronic Information: (] Llst ❑ Map- Descrlptio . <br />0 HOUSING ABATEMENT <br />FILE ADDRESS <br />EHD USE ONLY _ <br />NDERGROUND TANK (MONITORMOIREMOVAL) ee <br />Street <br />street Name <br />Cily <br />E] unit I <br />_ <br />2. <br />0 TATTOO/BODY PIERCING <br />"�71A <br />❑ MEDICAL WASTE FACILITY <br />❑ Unit2 <br />moi ( u1, -4^601e, , ` Vnitd : <br />4^ <br />Lt" <br />c IG <br />5. <br />Unit4. <br />6. <br />7, <br />❑ Units <br />N. <br />T <br />9. <br />❑ units <br />10, <br />Specific Date Range of Information Requested: From <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />_UNDERGROUND TANK (UST) CLEANUP SITE (IOP) <br />0 HOUSING ABATEMENT <br />THER CLEANUP SITE IN ON -LOP) <br />❑FOOD FACILITY <br />NDERGROUND TANK (MONITORMOIREMOVAL) ee <br />❑ DOG KENNEL <br />A7.AR000S WASTE OENERATORO< <br />fTEREP <br />❑ CHrcxRN RANCH <br />'PERWITED FACILITY <br />11 MOTEL/HOTEL <br />0 TATTOO/BODY PIERCING <br />0 POOLISPA <br />❑ MEDICAL WASTE FACILITY <br />OTHER (PLEASE SPEC <br />RECORDS <br />171 SOLID WASTE FACILIT A EHICLE <br />0 WASTETIRE <br />0 DAIRY <br />❑ WASTEWATER TREATMENT PLANT <br />11 PUMPER TRUCKIYARDICHEM TOILETS <br />C3 LAND UsE APPLICATION SITES <br />8:00 Am-6:00Pr4 - EXCLUDING HOLIDAYS. <br />3 files `oma <br />w,,}3. 0 <br />ply (w <br />1. List tip to ten addresses In the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(Qs). At least one Nle type MUST be selected. Fax to (2091464-0138 or mail to the address Indicate above,_ Address <br />ranges will not be accepted -for additional assistance with Nle 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 Nle& exist. An appointment for review will be confirmed approximately ten (10) <br />Th .I hl b h Id f xi um of five business da for review Appointments <br />days, <br />shoLld <br />3. A NIthat <br />sub'gD1y'Itted <br />4. Any <br />Future <br />after receipt of application. a taw e e or a ma an ys <br />be scheduled accordingly, <br />Is actively being worked on by EHD staff may not be immediately available for review. A new application may he <br />when the Nle Is available. <br />file not returned in the same, condition as released will be reorganized by EHD staff at the expense of the applicant. <br />Nle reviews by the same applicant may require a $106 deposit prior to review. <br />EHD USE ONLY <br />EHD 48.0 <br />1 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />