Laserfiche WebLink
DATE RECEIVED EHD LOG NU119EF <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT g <br /> �p11 600 East Main St. Stockton, CA 95202-3029 <br /> APR 1 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> TALHAt"TH PUBLIC RECORDS RELEASE APPLICATION <br /> eE1 (�iT�s C 1(�, �-- <br /> APPLICANT: C�1`-� �-�0�-� BUSINESS/AGENCY: <br /> ADDRESS: CITY/STATE/ZIP: <br /> PHONE (1): �� S^���� PHONE (2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE CESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �� DATE <br /> Electronic Information: ❑ List ❑ Map - Description: _ <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City —09 Unit 1 <br /> DC-sl <br /> ( 2. Unit 2 <br /> og <br /> 4. nit 3 <br /> s• Unit 4 <br /> 7. C)0 <br /> $• 1 % .n 1 Unit 5 <br /> 9. <br /> 10. nit fi <br /> Specific Date Range of Information Requested: From to r_ <br /> ENVIRONM NTAL HEALTH DEPARTMENT FILES ,, <br /> [ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ZHOUSING ABATEMENT ELPOLID WASTE FACILITYIVEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) KFOOD FACILITY 0 WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVALV k DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITYp<. MOTEL/HOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®TATTOO/BODY PIERCING POOLISPA LAND USE APPLICATION SITES <br /> ® MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) <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 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(20 9)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance 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 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 same applicant may require a$122 deposit prior to review. <br /> EHD USE ONLY <br /> t^d (A-1 I ,J 4- Lkn d o L-A r,&d S Go►� '�R/ (,a v <br /> 15 — <br /> d amaw <br /> EHD 4M6 <br />