Laserfiche WebLink
FAApr, 1. 2015 3 : 06PM • No. 0124 P. 1 <br /> CC R'�Gj G® SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> APR O 12015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES PUBLIC RECORDS RELEASE APPLICATION v1 <br /> APPLICANT: K Petrp�arvale BUSINESSIAGENCY: (gin,,✓tlPonme✓L <br /> ADDRESS: X33 D ��d r ee CITYISTATEIZIP:_(Tn�Uan c%t K( <br /> PHONE(1): 0�PH0NE(2): FACSIMILE: �IO-88G <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 review the requested records, <br /> HECK BOX TO EXPEDITE REQUEST-$130 FEE ASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT_ DATE .3 -3 1- I S_ <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> t2. t <br /> Street Name City w Unit 1 <br /> 41% or aw Doo- S roc VN pit r , tUnite.ffunif 3 <br /> S. <br /> 6. <br /> rJVIJC ��I� Unit4 <br /> 7. <br /> 8 - unit s <br /> 9. <br /> 10. ❑UnK s <br /> Specific Date Range of information Requeated: From tO <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,�RUNDEROROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY E]SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) F1HOUSING ADATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOODFACILITY DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTNHAZARDOUS MATERIALS ❑MOYELIHOTLL PUMPER TRUCKIYARD[CHEMICALTOILETS <br /> ,TIERED PERMITTED FACILITY E]POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIEIODY PIERCING RCOMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:0D AM-S:00PM(EXCLUDING HOLIDAYS) <br /> 1. List u to len addresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)484-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pre will be processed the next business day. <br /> 2, For assistance in identifying the nature and content of EHD records,please contact EHD atthe number noted above. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximatelyten(10) <br /> days after receipt of application. The flies 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$130 deposit prior to review. *"BOXED AREA-EHD USE ONLY"' <br /> LQ <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> oawvta <br /> ENO ae-oa <br /> Received Time Apr. 1. 2015 3: 15PM No. 8439 <br />