Laserfiche WebLink
V <br /> • SM 'ON Wdb� EIOZ t 'AONHuW uv P 4A193 Ba <br /> RDATE REC �D Mtit I< <br /> SAN JOAQUIN COUNTY . <br /> ENVIRONPAENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Nov <br /> 0'� <br /> Tolephone: (209) 468-3420 Fax: (209) 4640138 Web: www.sjgov.org/ehd 0 <br /> ENVi9ONMENTALHFATH PUBLIC RECORDS RELEASE APPLICATION <br /> P <br /> APPLfCANT: � CItyQ,h{ )�yY�G•1 UUSINESSIAGENCY: (f,is � <br /> ADDRESS: �f a q ) (�Yv1(A O / CITYISTATEiZIP:66 M E 12/9' <br /> y�D� <br /> PHONE }L} PHONE(2): FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentadva only-must be confirmed) <br /> ❑CHECK BOX TO EXPEOrrE RE ST-$125 FE (CASH OR CHECK LY)-REQUEST PROCESSED IN 3 BUSINESS DAYS . <br /> SIGNATURE OF APPLICANT . � DATE is 3La o )3 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USC ONLY <br /> street Street Name city Ll Unit <br /> ,. <br /> AP)A- -)l-� 09' bb <br /> 2. C)L�� <br /> Unit 2 <br /> ) 3Ilk <br /> )V 4. _4 0 e I`-d a lllJr Knit9 <br /> s. 3 480 � � mit 9 ,,w COMP <br /> 7. <br /> g, GGGU Units <br /> 9, ttSS w 1 1� eI� tr, n� 1 [� <br /> 90. Nov ✓1 IAJU <br /> � \CJ a >� — /� / op° p/unite <br /> Specific Date Range of Information Requested: From to <br /> IUUNDIERGROUNID <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �yfNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACWTY ry SOLID WASTE FACILITY�(ENIG.E r /I ,,1�3 <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT WASTE TIRE S `/ IIPCjWI TANK(MONITORINGIREMOvAL)Q` ❑FoODFACIUTY ❑DAIRY (- I+13 <br /> ABOVEGROUND TANK C]CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMEN�rPLANT <br /> HAZARDOUS WASTEl9GR000S MATERUALS:;;K, ❑MOTELIHOTEL ❑PUMPER TRUCKNAROICHEMICAL TOILETS <br /> Uj TIERED PERMITTED FAaUTYPOOLISPA []LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING XCOMPLAINTlRESPONSE RECORDS <br /> "R71 <br /> OTHER(PLEASE SPECIFY)\Ie-I'S <br /> WELL.AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:0012M(EXCLUDING HOLIDAYS) <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(249)4634.0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with File addresses,contact the END. Appitcatioros received atter <br /> 3:00 pm will be processed the next business day. <br /> 2. The END 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 END staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any rile not returned in the same condition as released will 5e reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the some applicant may require a$125 deposit prior to review. --*BOXED AREA-&HD USE ONLY . <br /> 40 <br /> u' ft= r s ProYfided by Shelf-PPR Col a(41Wi.a. stater Name: �I <br /> --.. .-...,�_... ... -- 9ih/27. ■ I <br /> �I <br /> Td Wd9Z:TO £TOZ TO •^ON 88626LVSTV 'ON XHd NUWBNNdn IQOL WW41 <br /> f� <br />