Laserfiche WebLink
'no 01/01/2010 00: 19 20933933P- HIDCAL INDUSTRIAL PAGE 01/01 <br /> ■ <br /> Iso €1 ff.4 1� ESAN JOAQUIN COUNTY EHD LOG NUMBER <br /> 1 <br /> EN`✓IRONMENTAL HEALTH DEPARTMENT <br /> SEP �. � 2015 <br /> 1868 East Hazelton Avenue,.Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgpv.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1Nf pyalk BUSINESS/AGENCYA140 Ml— IA"P41-, �Py�S <br /> ADDRESS: le''4e 7X1Ar'7_f fio' l' CITY/STATE/ZIP: 5�rd_OCT964 <br /> PHONE (1): )- j PHONE (2): '� FACSIMILE: <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 appoin t date and time to review the requested records. <br /> ® CHFCK BOX TO EXPEDITE REQUEST- E ASH CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> FILE ADDRESS <br /> Street# Street Name City EHD USE ONLY <br /> V ?� PAI �5�IC/Z7_,<-AY 5T ,01C"—COAA <br /> 2. <br /> 11-3 "7 <br /> 3, <br /> n ® ( //�� El Unit 2 <br /> (2 Flee o Unit 2H <br /> 1v`d7y� k Unit 3 `C <br /> 7. <br /> Erlunit 4 <br /> 8. <br /> (]'SITE MITIGATION <br /> 9. <br /> 10. <br /> ❑Unit 5 <br /> Specific Date Range of Information Requested_ From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> DERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> OVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> AZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEMICALTOILETS <br /> ❑TIERED PERMITTED FACILITY. ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(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.Applications received after 3:00 pm will be processed the next business day. . <br /> 2. For assistance In Identifying the nature and content cf EHD records, please contact EHD at the number noted above. <br /> 3. 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 /> 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 <br /> freviews by the same applicant may require a 8130 deposit prior toreview. — OXED AREA-EHD USE ONLY— <br /> ® <br /> CI Records provided by Staff-PPR Complete. Staff Name: <br /> Received Time Sep. 10. 2015 9: 13AM No. 9539 711115 <br />