Laserfiche WebLink
R <br /> / "^ca <br /> llo, 3119 EHPJMBER <br /> -, ' SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 168 East Hazelton Avenue, , CA 95205-6232 <br /> ( 2016 Telephone8(209)468-3420 Fax:(209)4164-0138 Web:www.sigov.org/ehd <br /> r3�Fs =• TP.LTIi PUBLIC RECORDS RELEASE APPLICATION <br /> BUSINESS/AGENCY:'&W'j0"v1 N cry PUB.W2� <br /> ADDRESS: /810 �•. by , CITY/STATE/ZIP:', C.+ Sao 5 <br /> PHONE (1): ZQc - t (Q&-, TLfjLf PHONE(2): FAX OR E-MAIL: 209-q&g -.2�1' j <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 ST-$1.- (C H ECK 0NL` -REgUEST PRQCESSEp IN 3.B SINESS_DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> 1. List up to ten address space o S ct t e pe(s)of files from the list below by checkln th appropriate <br /> box(es). At least one file type MUS selected. F t 209 464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted.Applications received a r3:00 pm will be processed the next business day. <br /> 2. 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 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 reviews by the same applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Informatlon Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH. <br /> FILES�TMENT FILE ADDRESS EHD USE ONLY <br /> UNDERGROUND TANK(VST) Street# Street Name City <br /> CLEANUP SITE(LOP) CONSUMER <br /> _4OTHER CLEANUP SITE(NON-LOP) W, ma j� /1�/�y/Fy�,�+ Itw,m /ON <br /> HAZARDOUS WASTE `� l // I <br /> TIERED PERMITTED�'AQILrT�' '/_ 1 "ath',ws P <br /> i�ABOVEOROVND TANK <br /> MST (MONITORING/REMOvAL) Ci <br /> F � y.,� Lj PWS <br /> ,HAZARDOUS MATERIALS a '�^Y/�f W• // l a h�w S l I WKP td� <br /> DO gPILLIRELEA9E REBPQNBE / I l <br /> / W-YAR QUALITY <br /> �SpLln WgBTE FACILITY/VEHICLE �-y' Ght�h <br /> FOOD FAGILITY �D> l/4� ��- ( I� �� � i •' // <br /> POOL/SPA <br /> (� Q i�„/_ SITE MITIGATION <br /> DAIRY S S �� D O J�• rC�j'PW'P t\:� <br /> LAND USE APPLK:ATION$rrE8 <br /> SEPTIC PUMPER TRUCK/ M HOUSING <br /> YARD/CHEMICAL TOILETS <br /> d I V�. YY1a-'hews rte= <br /> WASTEWATER TREATM2NT PLANT XHOUSINGABAT2 /� _ /1 �T <br /> T 'rJ{+ <br /> Q MoTEL/HorEL HENT COPA <br /> 2 - I l(M ► I�.v� /� � 1 16 /11.,„] <br /> CHICKEN RANCH/DOG KENNEL N ` ^ J V CUPA-U5Y l�� <br /> ❑MEDICAL WA5TE FAC141TY 8 „c, „ ( . I�1CIA <br /> r <br /> TATTOO/BODS'PIERCING <br /> WASTE TIRE SOO-WASTa" <br /> 9 <br /> COMPLAINT <br /> F-1 OY*IER(PLE'AsE SPECIFY): <br /> ACCOUN7INC <br /> tei4, 4H' 14 <br /> 10 <br /> "'"BOXED ARE/ •END U3E ONLY"' <br /> e L V All 114L sr . <br /> a(,D <br /> Received- Time' Oct, 1 U Z 612 : 35P'M_No, 0 18 0 ` ' <br /> EHD 48.06 <br />