Laserfiche WebLink
RUG-10-2010 15:52 Tetra Tech, Inc. 415 974 5914 P.01i01 <br /> rel �' '�� i �� SAN JOAQUIN COUNTY <br /> EN RONMENTAL HEALTH DEPARTME C <br /> UG ;; LU 10 600 East Main St. Stockton, CA 95242-3029 <br /> [J (HUf iV1 Lf9�PgpfN(209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov,orglehd <br /> 5 <br /> PERM ITISE-RO EOUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: "I BIJSINESSIAGENCY; Ifl-41�C <br /> ADDRESS: 55 S+,- oar CITYISTATEIZIP: r. Pv,�L4ca., • cjgt67 <br /> PHONE(1): ulT 9 ?LA-12.21 PHONE(2): FACSIMILE: qlF `t-7U" S�LLI <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Blease allow 10 business days from data of application submittal-"Tentative only•must be confirmed) <br /> CHECK BOX TO EXPLOrrE Ri`CIUEST-$122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: F] List© Map—Description: — -- <br /> FILE ADDRESS EHI7 USE ONLY <br /> Street# SUM Name City ❑Unit 1 <br /> 1. NOW n4-- N�S�..� 12�,.. l�cdi "qv QE5 ��� , .7 <br /> 2. _ Unit 2 <br /> 3 <br /> 4, nit 3 <br /> 5. <br /> � <br /> R4 <br /> 7. <br /> g, Gnit 5 <br /> s. <br /> 10. unit fi <br /> Specific Date Range of Information Requested: From �to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(LEST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYIVLHICLE <br /> TITER CLEANUP SITE(Nom-LOP) 0 FOOD FACILITY ❑WASTE TIRE 'J � <br /> NDtRGROUND TANK(MONIfORINGIREMOVAL) VC [3 DOG KENNEL. ❑DAIRY C: Z <br /> I)F -�� <br /> HAZARDOUS WASTE GENERATOR 04 ❑CHICKEN RANCH WASTEWATER YRFATMENT PLANT Z <br /> [j TIERED PERMITTER FACILITY ❑MOTELIHOTEL UMPER TRuCKIYARWCHEMICAL TOILETS <br /> ❑TATTooID04Y PIERCING ❑POOt.ISPA LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY BOTHER(PLEASE SPECIFY) A,'s,1TV Y NAf 144 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5.00pm(EXCLUDING HOLIDAYS) <br /> 1. Last uta 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)464-0136 or mail to the add ss 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$122 deposit prior to review. <br /> END uSE ONLY - <br /> W rj Po r o 0k <br /> 0K) LEIT8 'Outer A r <br /> IL <br /> CXR I . <br /> qa- <br /> ealD 49.06 $AFD i 5 r n i o7neria <br /> Gvt'yP4 /5�e—& 0 'W, <br /> cV p IV-2 (hle— G� TOTAL P.01 <br /> L1rsv4�c060171 1 , 5th a r�c-t, f6+5 <br />