Laserfiche WebLink
, QKEyE EHD LOG NUMBER <br /> SAN .JOAQUIN COUNTY <br /> Pk O fJ 24ir, ENVIRONMENTAL HEALTH DEPARTMENT `^ <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 (V� <br /> LafJ M0NAWfAL"MT1i Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd 5 f3 77 <br /> PEItMITSEf2+; CES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: cafc,� I TOPE.yS4?�\ BUSINESS/AGENCY: P61r�ry2i- U5l <br /> ADDRESS: 2-15"1 _fOCPILAt(, tb{ys. CITYISTATEIZIP: TDP/4^4;I CA (401, <br /> (1): 61� 1 <br /> "606^570 PHONE(2): FAX OR E-MAIL: tom <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 reviewthe requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT R"✓(ly�iC �.r 5-�i:,}l.s � DATE +55-17 <br /> 1. List up to ten addresses in the space be ow. Select the type(s)of files from the list below 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.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 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 EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) 1 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP)EAICONSUMER <br /> W Wkek <br /> OTHER CLEANUP SITE(NDN-LOP) �� M 4A, �dtkT�� <br /> e HAZARDOUS WASTE D DAIRY <br /> ❑TIERED PERMITTED FACILITY 2 S(II/,it5+- 5k�-,� vt <br /> �ABOVEGROUNO TANK f vfJ 1 1 �PWS <br /> 1UST (MONITORING/REMOVAL) r�, <br /> �AIARDOUS MATERIALS 9 1013 ('-1LVko-k S# 5+xv,+o IA" <br /> 6e f N /0" <br /> 1CQ <br /> HAZARDOUS <br /> RESPONSE 1 E 1 fJr r„VJWWATER QUALTY <br /> ❑SOLID WASTE FADILTTY/VEHICIl, 4 1531 h� <br /> ❑FD00 FA [CILITY \�(I y1 <br /> ❑POOL/SPA M I [/�.(y-'1�1} ���I(��/'�.�� .`dIEE MITIGATION <br /> ❑DAIRY S 1535 / •rl�t �"y / MA0v\ • \ a 1 '-W 1 , <br /> ❑LAND USE APPLICATION SITES n ` <br /> ❑SEPTC PUMPER TRUCK/ Lj HOUSING <br /> 6 1535 Mu`L� 4{ S�nt k�ov� 1v�c <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT CUPA <br /> ❑MOTEING LIH(OTBATEMENT T <br /> EL <br /> CHICKEN RANCH/DOG KENNEL <br /> MEDICAL WASTE FACILITY <br /> ❑TATTOO/BODY PIERCING <br /> SOLID WASTE <br /> WASTE TIRE Ml <br /> a��� <br /> COMPLAINT 9 ";'5-5r W1,lA �A �" �✓\ •'LT <br /> ❑OTHER(PLEASE SPECIFY): fit, S 11A000UWINO <br /> ,D 1��-�, Ma�t.� fj'"t. J'�t1v''C-C.9✓1 I�iYiI' <br /> "'BOXED AREA-EHD USE ONLY"` -' 7 <br /> 2 <br /> 3 � <br /> 0 Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br />