Laserfiche WebLink
DATE RECEIVED EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />j1 ENVIRONMENTAL HEALTH DEPARTMENT <br />Avenue Stockton <br />1868 East Hazelton, CA 95205-6232 <br />' Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: vwwv.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />)tL <br />k <br />APPLICANT: Tina Cheney / Geno Olson <br />ADDRESS: 902 Industrial Way <br />BUSINESS/AGENCY: Neil O. Anderson & Associates <br />CITY/STATE/ZIP: <br />PHONE (1): 209-747-0640 - Tina PHONE (2):209-367-628-1898 - Geno FACSIMILE: 209-333-8303 <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) <br />X CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT Tina Cheney — digital signature — ok to expedite DATE November 30, 2012 <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />Street # <br />Street Name <br />CityElUnit <br />1 <br />1. <br />1443 <br />Navy Drive {, '� I����CTc4�� <br />Stockton <br />1505 <br />Navy Drive 5 �e u� ` <br />Stockton CJ Iljri;t <br />2 <br />�' � <br />1023 <br />Pershing Ave <br />Stockton �G�t, <br />/IJ1041 <br />,p-unit 3 <br />r5-4. <br />Stoc ton <br />0 <br />';�i <br />1415 <br />Anderson St. <br />Stockton <br />0 I <br />i <br />r0 Unit 4 <br />7. <br />_ To view the HMMP (Hazardous <br />8• <br />Materials Management Plan) go to the <br />❑ Unit 5 <br />9. <br />' YJ <br />following website: www.sjoesdata.org <br />10. <br />__ETU' nit <br />wt. <br />-r. P <br />Specific Date Range of Information Requested: From <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />X UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY <br />X OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT <br />X UNDERGROUND TANK (MONITORING/REMOVAL) ❑ FOOD FACILITY <br />XABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL, <br />X HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTELIHOTEL <br />X TIERED PERMITTED FACILITY ❑ POOLISPA <br />❑ TATTOOIBODY PIERCING ❑ COMPLAINVRESPONSE RECORDS <br />to <br />X SOLID WASTE FACILITVEHICLE <br />❑WASTE TIRE )(% fjlps &/����' <br />❑ DAIRY K'.�'/,41 H 12 LHZ- <br />❑ WASTEWATER TREATMENT PLANT <br />❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />❑ LAND USE APPLICATION SITES <br />❑ 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 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 EHD staff may not a immeoiately av ilable,for4at <br />vi Anew applic tion ay be <br />submitted when the file is available. IZ'�i—IZ SPQ hctZJ�L i/1C.�G(C4'1t �n`Q'�+1s �/�S�,�d6/. XS.S-QIOro� �� INN�1iT" �bn�PS,4,-p�;��"Lh 4. Any file not returned in the same condition as re ease wi be reorga ze y EHD staff t e expens f t e applicant. <br />Future file reviews by the same applicant may require allp deposit prior to review. �' O E� AREA EHD USE ONLY <br />4 <br />NMI <br />&•oli..r�a <br />FIN / I�% % % .i ! i .:.�ii%�adi�i�:.i�tl►iyl <br />MEZZO <br />i <br />FHn AR_nF <br />41a1 I L <br />I <br />Z5 � <br />