Laserfiche WebLink
05/08/2009 11:25 7077483" PAGE 01/01 <br /> D j EHD LOG NUMBER <br /> L SAN JOAQUIN COUNTY <br /> MNY 2009 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, 09)Stockton,464-0 38 95202-3029 <br /> ENVIRONMENT HEAlA9tephone:(209)468.3420 Fax:(209)464-0138 Web:wwwsjgov.° <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:�eN t CK^ 4?A,TZ BUSINESSIAGENCY: (Zcaes <br /> ADDRESS: `'�t,7,—(-�} rtT�SjT r`�`2^C' Scl rT� LS9 c�. I��YtIC C� ( O +7 ! y�� <br /> PHONE(1): TC7T CJ PHONE(2): FACSIMILE: 7GT -f4S b� 4✓ <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application r„,nittal-"Tentaffm only-must be confirmed) <br /> El CHECK sox TO EXPEDITE REQU T $ B F (CA `' v)-REQUEST PROCESSED IN 3 9USMESS DAYS <br /> SIGNATURE OF APPLICANT DATE 5 g O <br /> Electronic Information: []List ap—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> n street A Street Name City ❑ Until <br /> tit(. lz* 5 C 5 OZ) <br /> 2. Unit2 <br /> 3. <br /> 4. nit 3 <br /> 6. '00unha <br /> 7. ❑ Units � )) <br /> Unit S <br /> io. <br /> Specific Date Range of Information Requested:From .a.( L- to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> -*NDERomouND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT SoLIn WASTE FACIUTYNEHICLE <br /> _. OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY '�WAZTETIRE �' IVM 11ll <br /> I UNDERGROUND TANKtMONITORINGIREMOVALb� Cl DOG KENNEL ❑DAIRY 7 <br /> HAZARDOUS WASTE GENERATOR R O CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT I <br /> REDPERMITTEDFAC1.1TY.',^ ❑MOTELlHOTEL ❑PUMPERTRUCKIYARD/CHEM TOILETS�I <br /> 13 TAT700MO13Y PIERCING-M ❑POOLISPA 13 LAND USE APPLICATION SITES <br /> ARDICAL WASTE FACILIr&_ 0 OTHER(PLEASE SPECIPY) <br /> WELL AND SEPTC PERMIT RECORDS ARE AVAILABLE FOR REVIEW• MONDAY-FRIDAY 6:00 AM.S:ODPM - EXCLUDING HOljo4 s. <br /> 1. Listup-tt ten addresses In,the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). Atleestone file type-MUST be selected. Fax to(209)464.0138 or mall to the addreaa-Indlcotad above. Address <br /> ranges will not be accepted—for addtBonal assistarice 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 hold 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$99.00 deposit prior to review. <br /> EHD Usti ONLY <br /> EHD ARAB W a aia=T <br />