Laserfiche WebLink
FROM ERAS enj......[aj, Inc. (WED)OCT 7 2000 14:02/ST. 14:01/Mo.TS00000666 P <br /> DATE ftt <br /> E E <br /> m"o E �l�lD SAN JOAQUIN COUNTY s EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCT 0 7 Z.. 600 East Main St. Stockton, www.sjgo%f.org/ <br /> (209)468-3420 Fax: (209)464-0101 388 Web: www.sjgov.orgle <br /> ENVIRONrV'(ENTHEALTN PUBLIC RECORDS RELEASE APPLICATION <br /> r `/ <br /> APPLICANT; (�) �a Q SINESS/AGENCY: rir\FY•� Z—_—i1V1ro'1MerN'r"l <br /> ADDRESS: I 3 3 Q 'ISTATE/ZIP: "', r <br /> PHONE (1): _���- O -a70(y PHONE(2): FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: . Time: <br /> (Please allow 10 business days from tlaW of ap li anon submittal••h 11WS must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST- 715 (C H ORCHECKONLY)-REQCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ID-'7-09 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> __ FILE ADDRESS EHD USE ONLY <br /> �Straet N Street Name City El❑Unit 1 <br /> r3 tJ1 rt YJ'" 'rC _C.- S�-pC I <br /> 3 �3 _--Ld=-r1.-Ct C f- 4 �J" D !] nit 2 <br /> 4• 003--- 1 <br /> -4uVMMe,— Ln �{v tIt <br /> 5. <br /> 6. - <br /> 7 Unit 4 <br /> 8. El . <br /> _ unii 5. <br /> IDAM <br /> Speck Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILrTYNEHICLE <br /> NER CLEANUP SITE(NON-LOP) ❑Fool)FACILITY ❑WASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOVAL)� ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR p( ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERmrrrED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMK:AL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERmrT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 Am-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)4640138 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 be immediately available for review. A new application may be <br /> submitted when the file is available. <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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHO USE ONLY <br /> EHO 8846 <br /> $127109 <br />