Laserfiche WebLink
RECEIVED � <br /> DATE RECEIVED EHD LOG NUMBER <br /> DEC. 3 0 2014 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENTAL HEAL 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PERMR/SERVICES %Iephone: (209 )468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECO,RQS RPLEASE APPLICATION /l <br /> APPLICANT: USINESS/AGENCY: <br /> ADDRESS: `' fit CITYISTA EIZIP: C a p ' <br /> PHONE (1). PHONE(2): Q FACSIMILE:_ <br /> Phase allow 10 busitiess days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange Ian ap of/tmen date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$1 ETAS CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS D YS <br /> SIGNATURE OF APPLICANT A DATE_&Zydi/Z <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE LY <br /> Street# Street Name City I 'MEl unit 1 f / <br /> `7 (�q3-7 <br /> f 17 /1 e1 / l �9 z �CCCC�)777 <br /> 106 <br /> fw I T,ND cOr� s <br /> 4K Z33j o9 5-5 cols <br /> 5 �1 nLAO <br /> it3 ?�) <br /> 6. /10 7 �— 00 nit <br /> IF <br /> �T n,,I�y1,p�.�. <br /> r0 P .( I ' GIM 7 / Z Cl1 ❑Units <br /> 9. <br /> 10. <br /> ❑unit s <br /> Specific Date Range of Information Requested: From i 3 to <br /> t ENVIRONMENT LA. ALTH DEPARTMENT FILES <br /> / <br /> :aUNDERGROUND UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILRYIVEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ElDAIRY <br /> 'ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ,HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ,,,--❑pppLAND USE APPLICATION SITES <br /> F-1TATTOOIBODY PIERCING 06OMPLy�A(NTIRESPONSE RECORDS OTHE'' LEASE SPECIFY) ✓q-11 h/(� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 800 AM-5:00PM(EXCLUDING HOLIDAYe4 yry� <br /> 1. List uD to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate 1_. .�,r��, <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Addres <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. I <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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ***BOXED AREA-EHD USE ONLY"** <br /> r- - <br /> /w v vlts{ a <br /> ❑ Records provid d by Staff-PPR Cofinplete. Staff Name: <br /> EHD 48-06 <br />