Laserfiche WebLink
08/12/2009 08:23 9252741703 ARCADIS #0504 P.002/003 <br /> RVIED 1.r/ SAN JOAQUIN COUNTY %WW EHD LOG NUMBER <br /> AUG 1 $ Zp09 ENVIRONMENTAL HEALTH DEPARTMENT r <br /> 600 East Main 5t. Stockton,209) 13 95202-2708 ww08 5 <br /> .3 <br /> sAVI R NN SERVICES�1epnPUBLIC RECORDS one:(209)468-3420 Fax!(RELEASE APPLICATION <br /> www.sjgov.org/OhLdf5 (/ (/ <br /> APPLICANT: LeAia le-ay-\l BUSINESS/AGENCY: �Cf0.�1S <br /> ADDRESS: 20S*7 North Main StrtGf• CITYISTATEIZIP: 04Tryu f- (-keekt CA gy$96 <br /> PHONE(1): (gLn gb5-57a 11 PHONE(2): FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: i ��L27Q Time: /0=OO AM <br /> (Please allow 10 business days from date of appllcadon submittal--Terrtadye only.must be confirmed <br /> CHECK BOX TO EXPEDITE REQUEST-$115.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU 1f1'S R <br /> SIGNATURE OF APPLICANT - DAA <br /> Electronic Information: ❑ List Iii Map-Description: H dC Q <br /> FILE ADDRESS EHD USE ONLY <br /> street R Straat Name .. ..._. . city ❑Uaisf ' <br /> L ,114',01'to <br /> 2- 3345 IJ, VSP_H JrF7 ST-RE 5 OC ra t <br /> 3. l)(8 Ehttxv S ro41C OG- ,Ab < <br /> 6 4. 3o sib . : :' <br /> s• Fn. J r S a <br /> 6• / /PJMAVra c� <br /> SI QP <br /> it 4 <br /> 7. re — rani 5,T-L TqS El Unit 5 <br /> Flet <br /> 9 . SmW- 7k I 1 , <br /> 10. 6 A). 5a.n 3 v sz la C vi N o s t 6 <br /> Specific Date Range of Information Requested: From 1850 to A(-Z) <br /> I <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILESUNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Kx�T'S'O'LID WASTE FACariYNLHi <br /> OTHER CLEANUP STTE(NON-LOP) rs� Fool)FACILTfY _: &WASTE TIRE t" - <br /> UVN��DE�R��G�R�O�sUND TANK(MOMTORINGIREMOVAL)�/ ❑DOG <br /> El DAIRY W i7 <br /> ®KvARDous WASTE GENERATOR o�, ❑CHI gLWASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILNYo( ❑MOT L PUMPER TRUCKl1'ARDICHEMICALTDI R?'* v('flf <br /> (]TATTooIBooY PIERCING EI P A rte+LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑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 tan 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)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. Afile 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$115.00 deposit prior to review. <br /> ENU USE ONLY <br /> ou need further assistance please contact Diane Marotta a(209)468-3425 dl . Thank You — <br /> v' 3 <br /> EFO <br /> mrrzoos <br />