Laserfiche WebLink
[RMD SAN JOAQUIN COUNTY EHOLOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> OUT 3 0 2008 600 East Main Street, Stockton, CA 95202-3029 (,A/) t7Z Telephone: (209)468-3426 Fax: (209)464-0138 Web; Wwwsjgov.org/eENVIRONMENT HEALTH 1 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1 � BUSINESS/AGENCY. <br /> ADDRESS: �d� ,S'ir/ s~ 5r� A02 cltyrstataalp �is,•ro <br /> PHONE(1):'t:Tr< PHONE 12); _FACSIMILE: ,�7� <br /> TENTATIVE"APPOINTMENT DATE: Time:�I/LiRM <br /> (Please allow 10 business days from Nat®of appG tion submittal-'TsnrS17"only-must ba conflnnsd) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST- E(CASH CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE U �O <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street M Street Name Cly <br /> 1, Q E] Unit 1 <br /> 0 <br /> it R 1( (I 5 E5(,vv <br /> ❑ "Unit 2 <br /> 3. it 1t ft p it It 6S �i90 <br /> a, a e h n it , .tt o ,oEs,,vo ,� ;ual <br /> aeM 7733 t( u <br /> It V a It uyt(oL) -g,-s,A/0uwvr UnI14 <br /> 0 it it it a 1% <br /> it ❑ Unit <br /> 8' It <br /> It tt t< li (L Noun;i 3dU A/y <br /> 9' 3 1fLC�T � li Uhf <br /> 10. ❑ UnR e <br /> 1, tN 0 4 <br /> pec fl Date Range of Information Requested: From <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �j I ej Or <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ARATEMENT Cl SOLID WASTE FACIU YNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) M FOOD FACILITY ❑WASTE TIRE •i� 3r <br /> WUNDERGROUND TANK(MOWTORINGIREMOVAL)0(' CI DOD KENNEL ' E3 DAIRY tLt��C <br /> N HAZARDOUS WASTE GENERATORd" 0 CHICKEN RANCH O WASTEWATER TREATMENT PLANT / <br /> 13 TIERED PERMITTED FACILITY ❑MOTEIJHOTEL ❑PUMPER TKUCK/YARDICHEM TOILETS Alyn S <br /> O TAl7O0/BODY PIERCING ❑POOUSPA 0 LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) a 0) <br /> WELL AND SEPTIC PeRM1T RECORDS ARE AVAILAULE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:DOPm - 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 appropriate <br /> box(es). At least one file type MUST be selected. Fax10(209)4640138 or mail to the address indicated above Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the END. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END file$I exist., An.appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will'H'e held for;a maximum of five business days far review, Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END 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 END staff at the expense of the applicant. <br /> Future flie reviews by the same applicant may require a 5105 deposit prior to review. <br /> END USE ONLY <br /> a a <br /> END 4e-0e 6/04/05 <br /> PUBLIC RECORbB RELEASE APP FOAM <br />