Laserfiche WebLink
am IJul. 14. 2016 12: 52PM No. 0894 P. 1 <br /> a� E G i D V E D SAN JOAQUIN COPut% <br /> EHD LOG NUMBER <br /> E <br /> F ENVIRONMENTAL HEALTH it <br /> G ` <br /> U JUL1 l; tS 1868 East Hazelton Avenue, Stockton,CX 95205-6232 , <br /> Telephone: (209)4683420 Fax:(209)464-013a Web:www.$)gov.or9/ehc1 —E `ee <br /> j ENVIR( NViENTPLHEALTH PUBLIC RECORDS RELEASE APPLICATION i <br /> APPLICANT: W Ova- BUSINESS/AGENCY: 'G—r�124.5 �r1Vfr'or..++e <br /> ADDRESS: CITYISTATE2IP:_ Y1, ,J" r- qtt$—�l I <br /> PHONE(;): SIO- -N7-y&SS—,CSO'LL PHONE(2): FAXORE-MAIL: 0_n fea)��ras, fZ <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 REODUTT- FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> 1. List up to ten addresses in the space below. Seleetthe type(s)of files from the list below by checking the appropriate <br /> box(es). At feast one file type MUST be selected. Fax to(209)464-0138 ormail 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 of EHD records,please confect 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 fora 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$130 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM.S:aaPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map–Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL ,t /� dAI <br /> HEALTH DEPARTMENT FILE ADDRESS y EHD USE FILES <br /> �UNOERGROuNo TAHK(UST) Street# Street Name city <br /> CLEANUP SITE(LOP) 6 a 1 ❑CONEUMER <br /> OTHE+I CLEPNUP SITE(NON-LOP) ' `� 13O El //Arcdp �`d • L r�i'1' <br /> FATArmous W.sra p ONNr <br /> TIf O PERMmEG FAmK = 1/T ,1ry,� <br /> �AEIO EGRouvD TANK f�dv •"" ' "� •-0 <br /> JJI UST (MONrtORWGI REMW (��/ y^J 1 f e r ❑PW9 <br /> HTRDOUS M&TENALe ' B(]� <br /> y Si �{ (�Q.rµ�O O17JLi(1-1 _ IA. A., .nA <br /> FILURELEA6E Re9PONSE <br /> F <br /> SOLD WP1"`i`i �G✓�(1.`I EV Idv�1• j{.P�L`ct�M IV' 0(.��yP �wc.ea aunLm Il�� <br /> EIE PCILT'/VEHICLE d <br /> roon FACILITY I (I'vY ` <br /> cf <br /> 1�6Q1"S <br /> E]POOL ISPA ITE MITIWTCN <br /> Q DAIRY 6 <br /> TSI L D UEE ApP,uuTION SITES <br /> 1� ❑Hou3INo <br /> ❑9EPnC PUMPER TRUCK/ E <br /> YARD I CHEMICAL TOILETS <br /> 9WA5TEWATE1t TREATMENT PLANT IYIICUPA <br /> HauBINOAMTEMENT T <br /> ❑MOTEUHOTEL <br /> ❑GHIcKEN RAN.I Dan KENNEL CUPA (ACJ <br /> e <br /> MEOIUL WasrE FACILITY ' <br /> TATTOdBODY PIERGNG QA to WMTE <br /> I�WASTE TIRE g <br /> COMPMq <br /> OTHER(PLF 5E SPECIE); ❑Accouem0 <br /> 1d <br /> ED AREA-EHD USE ONLY.. <br /> 0 0 0 <br /> •. rout d V5 E <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> Received Time=Jul. 14. '2016-12:55PM—No. 091J <br />