Laserfiche WebLink
Aug. 10.2011 0° : 59 STON SOLUTIONS INC OAKL 5100910 PAGE. 1/ 1 <br /> RECEIVED <br /> DATE RECEIVED EHD LOG NUMBER <br /> A� l� <br /> O 201 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENTAL HEALTH 600 East Main St. Stockton, CA 95202-3029 <br /> PERMIT/SERVICES Telephone; (209) 468-3420 Fax: (209) 464-0138 Web: wv✓w.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: UU0 BUSINESS/AGENCY.,U Si„"” } IvhuLa <br /> ADDRESS: tu (STM "kqK s r G," _l _ CITYI3TATE/ZIP:_6;U� C`4 q <br /> PHONE(1); X60- -4b8 18ci—t' PHON 2 FACSIMILE; <br /> TENTATIVE*APPOINTMENT DATE; ` Time:_ <br /> (Pleaso allow 10 bueineae days from dat of ppllcatlon submittal-*Tentative only-must he confirmed) <br /> ❑CHECK BOX TO EXPEDITE RET 12 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> _ <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE:ADDRESS EHD USE ONLY <br /> Street# St root Name city 1 <br /> � nit 1 <br /> _. <br /> O �inv>�-. ?o _ ' r W.� I, 67S Gf>�yl <br /> V 2. <br /> Unit 2 <br /> 3. OU <br /> ... <br /> 4. nit 3 <br /> 6. <br /> 6. it 4 <br /> 7. <br /> ❑Unit 6 <br /> 9. <br /> 10. Unit 8 <br /> SpecUlc Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT OLID WASTE FACILITY/VEHICLE \INJ J <br /> THER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE 1 <br /> NDERGROUND TANK(MONITORINGIREMOVALO� ❑DOG KENNEL ❑DAIRY <br /> AZARDOUS WASTE GENERATOFV,, I .I CHICKEN RANCH tMASTEWATER TREATMENT PLANT <br /> ERED PERMITTED FACILIT&-�_ ❑MOTEIJHOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOL/SPA NO 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-5:00PM(EXCLUDING HOLIDAYS) <br /> I <br /> 1. List up to ten 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)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 some condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the some applicant may require a$122 deposlt prior to review, <br /> ,� EYiO USE ONLY <br /> ..rc� n 7T <br /> l tp niS °r r0 U I es <br /> F;HP ae-ve <br />