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1111V14VIVVU ..Z''r raA 0001/001 <br />RWY\E® <br />SANJOA C EHD LOG NUMBER <br />QUIN OUNTY <br />NCV 10 2010 ENVIRONMENTAL HEALTH DEPARTMENT <br />rr���'aeu� 600 East Main St. Stockton, CA 95202-3029 <br />ENVIRONMENTAL HE Wphone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orgleh <br />PERMIT/SERVICES 7 <br />PUBLIC RECORDS RELEASE APPLICATI f/ <br />APPLICANT:_{[_ Epawa ' BUSINESS/AGENCY `a4Ei tar l sm-weE5 <br />ADDRESS: 1.414 tl�p¢Lnn11 aVF CITY/STATIE=P: S --rj,Cp r(A q}gtr <br />PHONE(1): (9(b} 0--o7_ { PHONE(2): (R((,)841 -7$i$ FACSIMILE: (glO490-0Gc'7 <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal-trantadve only- must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUE FE OR CFJE9K ONLY) -REQUEST PROCESSED IN 3 BUSINS DAYS <br />SIGNATURE OF APPLICANT DATE S ES710 <br />Electronic Information: ❑ List Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />.. Street # <br />ISO I <br />._'_-... _.. Street Name <br />ST <br />city <br />WOt <br />C S �It171 ❑/unit <br />010, <br />2 <br />123r <br />t 1SC cPckt�.trp ST <br />l <br />3. <br />O <br />cuw-F e <br />S <br />nit <br />nit <br />4. <br />5. <br />6. <br />T. <br />^ <br />_ <br />❑ Unit s <br />B. <br />9. <br />...... <br />........... <br />Unit s <br />10, <br />Specific Date Range of Informadan Requested: FromAL.t_ to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ED HOUSING ABATEMENT El SOLID WASTE FACILRYNENLCIF / <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE <br />UNDERGROUND TANK (MONITORINGIREMOVALO` L] DOG KENNEL ❑ DAIRY U-0 r <br />HA7ARDOuS WASTE GENERATOR OC ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />❑ ❑ TIERED PERMITTED FACILITY ElMOTELIHOTEL I / - TATTOOIBOUY PIERCING ❑ PUMPER MICAL TOILETS <br />❑ POOLISPA [:1 LAND USE APPLICATION <br />ION SSITES <br />❑ MEDICAL WASTE FACILITY [] OTHER (PLEASE SPECTrY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW; MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresaea 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 (2091484.0138 or mall to the at,(dress Indicated above. Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received atter <br />3:00 pm will be processed the next business day. <br />2. The EHD will notify the applicant H 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 some applicant may require a $122 deposit prior to review. <br />