Laserfiche WebLink
END LOG NUMBER <br /> &ATE 2ECEIVEb��_-& SAN JOAQUIN COUNTY <br /> E ENVIRONMENTAL HEALTH IDEFARTME14T <br /> cr. ALIG 2 a M 1668 East Hazelton Avenue,Stockton, CA 95205-6232 <br /> ¢19V Telephone: (209)468-3420 Fax: (209)464-0138 Web:WWw.sjgov,org/ehd <br /> %IROH€ViENTALHEAL i' PUBLIC RECORDS RELEASE APPLICATION <br /> BLISINESSIAGENCY: �;L)V (OVA m1fi nL <br /> ADDRESS: S CITY/STATE[ZIP: wror)a <br /> PHONE (1): �V PNONE(2): FAX OR E-MAIL: <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 appolntmenf date and time to revlaw the requested records. <br /> ^ space be Select e types) of fEle�s from the Ilst below by E <br /> 49 <br /> .I., po,,(',`IIo11N�IM1P,I! ^�il�' .'i �1 - u ,� . �...I <br /> SIGNATURE OF APPLICANT Q/1 <br /> king he appropriate <br /> 1. List up to ten addresses in th sp <br /> box(es). At Ieast one flie type MUST received selected. Fax <br /> o 00 pm <br /> ( 64 1processed the next or rm <br /> address <br /> businesstday.ed bove. Address <br /> ranges will not be aceepted.Applications <br /> 2. For assistance in Identifying the nature and content of END records, please contact END at the number noted above. <br /> 3. 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 /> he applicant. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of t <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•5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic lnformation: ❑ List❑ IJ12p-Description: to ✓ I <br /> Specific Date Range of information Requested: From _ NI OD - <br /> E4cU1!rN, Ep Ary FILE <br /> LIP <br /> E <br /> �E. I� EHD �!S E ONLY <br /> UNDERRROUND TANK(UST) Streot# Street Name y <br /> CON.:VMAP <br /> CLEANUP SITE(LOP) _ t'r5 Qom^,)^-V+(` I �-+ , -S'�' C 1 L�� '" / '-" /� <br /> THEP CLEANUP aUE(NOW-LOP) -T 5^ "L / aSP L-O <br /> DAIRY <br /> HAiARODUS WASTE <br /> IERED PERMITTED FACILITY <br /> 2 <br /> 11ADOVEGROUNO TANK []PWB <br /> NrJI UoT (MONITORING/REMOVAL) <br /> eYR 9 <br /> IBPILIJRnEASt <br /> Izl Hn:nRDDUG MATERInL3 RESPONSE tt1 WATER <br /> OJAUTTT <br /> SOLD WASTE FAOILDY/VEHICLE 4 kSA 01— l * 1 <br /> ODD FACILITY (•` ' 1 Ar $ITe Ilu*Dr pTION <br /> POOL/SPA <br /> DAIRY <br /> �����...(((���LAND Use APPLICATION SUES ❑Hwsm <br /> 7\/' PTIC PUMPER TRuOK/ Q <br /> AFD/CHEMICAL TOILETG <br /> WASTEWATER TREATMENT PLANT CUPA <br /> F1 HOUSNO AEATEMENT T <br /> rl MOTEUHOTEL ,'CUPA-UST <br /> Il CHICKEN RANCK/DOG KENNEL <br /> F1 MEDICAL WASTE FACILITY R <br /> ❑TATTOOIBODY PIERCING Soup WA.TTr. <br /> rj WASTE TELE S <br /> rl COMPLAINT <br /> OTHER(PLEASE SPECIFY): [3]ADCOIATINO <br /> 10 <br /> ••'BOXED AREA.EHD USEONLY— <br /> r 1 0001 eived Timeg(Aug• 25. 'F2016'0 8:24ANTNo. 1141 <br /> 11 <br /> EHD 4846 <br />