Laserfiche WebLink
05/13/2008 09:54 FAX Z001/001 <br /> DA7F�E) D EHD LOG NUMBER <br /> �E( I lul u IL��- SAN JOAQUIN COUNTY <br /> `� ENVIRONMENTAL HEALTH DEPARTMENT aWN%� <br /> MAY 1. 3 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ hdS D <br /> ENAIiRONhltfvi riEALTH PUBLIC RECORDS RELEASE APPLICATIO <br /> pEp,nAIT)SFRVICES <br /> APPLICANT: 7(lI\11 S 5G„ dJir BUSINESSIAGENCY: C'ylditan S ylirQs <br /> ADDRESS: 7t't34 Mtrr'Goni 1�v-t 4tE G <br /> PHONE(1): Q16NfGC 02-01 —PHONE(2): FACSIMILE: qli 11's 0(!9(3.3] <br /> TENTATIVE”APPOINTMENT DATE: Tlmc6ft�') ."'9- <br /> (Please allow ten business days from dao of application submittal.'Tentative only-must be Conti-rill d) <br /> ❑ CHECK BOX TO EXPEDITE REQUU�S^T--$$98.0 EE(CA OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �l UU"" , Nl DATE V)" 101 <br /> Electronic Information: ❑ List 0 Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Streets Street Name City 0unit I <br /> 1• 70r6 IV F01- 3 U"W ►a L1c}anno r112 IZ'ilt No <br /> 2. 1115 w• jSY /i-rK 5l,rctYac�k0+t no db/�ktP oR r3 Unit 2 <br /> 3. Ho4 r-f£Mo+1{ fat* W4,xor^ �fto2 <br /> a. Li;LL1 V00 1Jvire'­r' r'0 5k#'cwrvn l Unks <br /> 5. yp5 rvtonfCa2 rzaf GGu.tF3/1 u�tD noy '{I(„o�,e - - ;��' <br /> 6. 405 0 Llnt0in 5 �_ 4E5/noyFtn/notomp t r,a� <br /> 7. 611 w Frtzmorif 5�ftc+ 4yCoZ� W ;I <br /> 8. 171 <br /> Unit 5 <br /> 9. <br /> nit 6 <br /> 10. <br /> Specific Date Range of Information Requested:From 'g gfA•rl l 5-} to 20o g <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> til UNOEROROUNO TANK(UST)CLEANUP SITE(LOP) ❑HOusiN0 ABATEMENT �{SOLID WASTE FAGLmNEMCLE(Y_ <br /> CV-DrHER CLEANUP Sim(NON-LOP) 0FOOD FACILOY 9WASTETIRE A/ <br /> CLUNDERGROUND TANK(MOMTORINGIREMOVAL) ❑DOG KENNEL O DAIRY <br /> Mt HAZARDOUS WASTE GENERATOR OCHICKEN RANCH I:WASTEWATER TREATMENT PLANT <br /> CK TIERED PERMITTED FACILITY 0MOTELMOTEL ❑PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑TATTOOISODY PIERCING I:POOLISPA 0 LAND USE APPLICATION SITE$ <br /> ❑MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVALABLE FOR REVIEW - MONDAY-FRIDAY 9:00 AM-5:00PM - ExCLDDING HOLIDAYS. <br /> 1. List up 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(2091464-0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> 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 <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 /> 3. A file that Is actively being worked on by the EHP staff may not be Immediately available for review. A new application <br /> may be 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> RHD 4846 1012MT PUBLIC RECORD$RELEASE APP FORM <br />