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0 <br />DEND LOG NUMMA <br />U J SAN JOAQUIN COUNTY <br />APk ,l LO06 ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue. 3rd Floor, Stockton, CA 952.02-2708r� <br />ENVIRONMENT HEALYephoae: (209) 468-3420 Rax: (209) 464-0138 Web: www.sjgov.lxg/ehd �7W <br />PERMIT/SERVICES PUBLIC RECORDS nLEASE APPLICATION ,/ ���„/// <br />BUSINESS/AGENCY: <br />PADDRES): 7�ta 940—`JO$3 PH NO r:m: T, 7F:�uv�t_Ino FA7CSIMILE: los 785--9_7125 <br />TENTATIVE' APPOINTMENT DATE: �tiursdn l ripr. 13 Tima:_ <br />(Please allow 10 business days from date of appllcanGn submtftal -'Tentative orlty -mus•t be conflrmad) <br />EWCHECK BOX TO EXPEDITE REQQU�EST-s93.00 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT —DATE <br />UNITDISTRIBUTION] <br />P UnK 1 Q Unh 2 ❑ Unit 3 M Unh 4 CI Unit S ❑ Units ❑ Other (electronidlistslmaps) <br />❑ SOLID WAS TO FACIUTYNEHICLE <br />W OTNER CLEANuP SITE(Now-LOP)0F000 <br />FACILITY <br />11 WA3TEnW-- <br />stmt* - <br />FILE ADDRESS EHD USE ONLY <br />Street Name City <br />1. <br />3900 - <br />b-3.9 <br />w °-9 AQAO <br />2. <br />i2 Atfi <br />l7 MOYEUHOTEL <br />3. <br />M TATTOOIBOOY PIEWNG <br />tJ POOL/SPA <br />4. <br />M MEDICAL WASTE FACILITY <br />:7 OTHER (PLEASE SPECIFY) <br />5.4ft <br />WELL AND SEPTIC PERMrT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY -FRIDAY 8:00 AM5:00PM - EXCLUDING HOLIDAYS, <br />AL <br />10. <br />Specific Date Range of Information Requested: From to _ <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />O UNDERGROWD TANK (UST) CLEANUP SrTE(LOP) <br />0 HOUSING ABATEMENT <br />❑ SOLID WAS TO FACIUTYNEHICLE <br />W OTNER CLEANuP SITE(Now-LOP)0F000 <br />FACILITY <br />11 WA3TEnW-- <br />DrUNDERGROUNDTANK (MOMTORINGIREMOVAL) <br />O DOG KENNEL <br />O DAIRY <br />l9'HAZARDOU5 WASTE GENERATOR <br />0CKICKEN RANCH <br />❑ WASTEWATER TREATMENT PLANT <br />17 TIERED PERMITTED FACILITY <br />l7 MOYEUHOTEL <br />Cl PUMPER TRUGMARDICHEM TOILETS <br />M TATTOOIBOOY PIEWNG <br />tJ POOL/SPA <br />0 LAND USE APPLICATION SITES <br />M MEDICAL WASTE FACILITY <br />:7 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMrT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY -FRIDAY 8:00 AM5:00PM - EXCLUDING 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 <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 4fi4-0138 or mail to the address <br />indicated above. Address ranges will not be accepted -for additional assistance with file addresses, contact <br />the EHD. Applications received after 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 <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for revlew. Appointments 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 <br />application 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 <br />applicant. Future tile reviews by the same applicant may <br />END �2- <br />TnN05 <br />E0/Z0 39Vd <br />EINIl-1176NOD E3 <br />a ��J.V V uclmo'�a Ni.v . <br />GZL688LEOE LI:ET 900Z/L0/00 <br />