Laserfiche WebLink
I k/14/2014 2:46 PM 15597026522 412094640138 <br />1■ 1 <br />■ DATE RECE7_ - �: <br />■ -° b I l SAN JOAQUIN COUNTY HD E <br />■ ;1_ <br />F !� <br />InsENVIRONMENTAL HEALTH DEPARTMENT <br />.JUL 14 ?014. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www,sjgov.org/ehd <br />1VERpNMFNTALE1EAi,[H PUBLIC RECORDS RELEASE APPLICATION <br />�rnadITICI-R�riCES <br />APPLICANT:J6a., Qzpp X16 BUSINESS/AGENCY: <br />ADDRESS: '71 SKU)AA-P— 13rJ?1 CITYISTATE0P:��IS , (,A 2361 ? <br />PHONE (1): 55I. b57.172,5 PHONE (2): FACSIMILE: 559•�0� toc� <br />I'M <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- $1 5 EE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT �r DATE <br />Electronic Information: <br />❑ List ❑ Map —Description: <br />FILE ADDRESS <br />fb <br />EHD USE ONLY <br />❑ Unit 2 <br />Street <br />Street Name city <br />2. <br />u <br />� % <br />ovf:N'0 <br />3. <br />�'�%!J <br />N� c�>�� <br />El Unit 3 <br />4. <br />aa• <br />f <br />16 <br />14 IFr <br />'�; D(� urur 3 , CCS' <br />❑unit 4 <br />s. �'�� <br />��'��, � � (� � � 1' � <br />7. <br />"� <br />C C i <br />a�J_i'"�'r �-l�tit <br />R�� <br />H Mt'��7 ,�iGC-l'�� <br />❑UnttS <br />8. <br />• <br />9. <br />'Unit 6 <br />10. <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGRDUND TANK CLEANUP SITE LOP II�� <br />(UST) (LOP) ❑ MEDICAL FACILITY SOLID WASTE FACMYIVEHICLE ��-, <br />OTHER CLEANUP SITE (NoN-LOP) ❑ HousiNG ABATEMENT ,KWASTE TIRE, y <br />UNDERGROUND TANK (MONITORINGIREmoVAL) ❑ FooD FACILITY]AIRY <br />OVEGROUND TANK ❑ CHICKEN RANCHI DOG Q <br />KENNEL WASTEWATER`fREATMENT PLANT <br />•2HHAZARDOUS WASTEMAZARDOUS MATERIALS ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEmicAL TOILETS <br />14 TIERED PERMITTED FACILfr`( POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOOISODY PIERCING CDMPLAINTIRESPONSE 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 flies from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (209)4&4-0138 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 />Z. 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 fries 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 $925 deposit prior to review. *BOXED AREA. EHD USE ONLY*** <br />)(`..SJ -LI -7'5I $ XSJ �Ztc�O 7G'� 1PwrI% , <br />1 <br />Vol I ft r O.s <br />Lk � vi�l.v IISI' or 1'♦�� � <br />Dom` l� iaXQ <br />in u") k- °fit f7o ? A37) V ae- 1751 W ,,j Ltf ,c <br />❑ Records provided by Staff -FPR Complete. Staff Name: <br />EHD 4846 <br />Received Time Jul. 14. 2014 2:46PM No -6581 <br />4nan4 <br />r� <br />