Laserfiche WebLink
rrom: 01/04/2008 14:08 #818 P.001/001 <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> JAM 0 4 2008 ENVIRONMENTAL HEALTH DEPARTMENT 2 7� <br /> 600 East Main Street, Stockton,CA 95202-3029 �`/� <br /> ENV1RU( .f 9EN hf_:A H, Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgo . g/eh <br /> VT:NMI 1i!SERVICEt <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ci Ar,$ H 2 BUSINESSIAGENCY: �RUJ'✓U•'�Clrr / Sa/r"w{ ;SYJH <br /> ADDRESS: �-Q- _81Y )(0h 4g2 , 7(24 e?SZg1, <br /> PHONE(1): �I�C+ A'/�7'-S_36pZ PHONE(2): C�7'S�j �"fo lS FACSIMILE:t�; r���"Gj�/r/� <br /> TENTATIVE`APPOINTMENT DATE: C1d Time: 7 � ' <br /> (Please allow 10 business days from date of application submittal-•Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST- 98. FE MCH OR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � 111 DATE I� 7 <br /> Electronic Information: ❑List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 1. 75 1 ; r A:V S�I etc <br /> 2. Z`L1f PrV? S U� ,. p.M." El Unit 2 <br /> 3. i( 3 Grow A +�e_ LS IH <br /> U <br /> - --- nit <br /> jib <br /> 6. <br /> 7. <br /> ❑ UnitS <br /> 8. <br /> 9. <br /> ❑ Unit6 <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> /' ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> .8 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) OFOOD FACILITY OWASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) M DOG KENNEL 0 DAIRY <br /> •HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH El WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTEL/HOTEL El PUMPER TRUCKIYARD/CHEM TOILETS <br /> 0 TATTOO/BODY PIERCING D POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW-MONDAY-FRIDAY 8:00 AM-B:OOPM -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 208 464.0138 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$98.00 deposit prior to review. <br /> EHD USE ONLY _ <br /> EHD 4605 WEB SIBrd007 <br />