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DATE RECEIVED SAN JOAQUEi COUNTY EHD LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avemlc, 314 Floor, Stockton: CA 95202-2705 341Telephone: (209) 468-3420 Fax: (209) 464A138 Web: www.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE .A,PPLICATION <br />APPLICANT: <br />y�l�P IA/bi.K.!!y BUSINESSIAGENCY: /( � �?NSI'L7�N7S <br />ADDRESS: 2$7i�Gtsr'I r�✓O (�[RiS[.O �S7,E d -m W NUT G+e>_�J� 04- jq f J <br />hh2 7 & FACSIMILE: g�r� �y�7 ��S <br />PHONE (1): R � �&�- � PHONE (2): <br />TENTATIVE" APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of appTicatlon submittal-'Tenmthre only -must be confirmed) <br />❑ CHECK BOX To EXPEDITE REQUES 93 0 EE ASH OR CHECK OILY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE A�2l�?00(p <br />Specific Date Range of Information Requested: From A VVU to iAcywr�.T <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />IfUNDERGROUND TANK (UST) CLEANUP SITE (LOP) Q HOUSING ABATEMENT grSOLID WASTE FACIL"IVEHICLE <br />ryQ7M'� Eli CLEANUP SUE (NON -LOP) ❑FOOD FACILrry WWASTETIRE <br />IM UNDERGROUND TANK(MONRORMGIREMOVAL) 0DOG KENNEL Er DAIRY <br />R'HAi.AR0003 WASTE GENERATOR MCHICKEN RANCH [YWAGTEwATER TREATMENT PLAN` <br />• TIERED PERMITTED FActLnT O MOTEL[HOTEL fir PUMPER TRUCK/YARDICHEM TOILETS <br />O TATTOO/BODY PIERCING ❑ POOLISPA (4 LAND USE APPLICATION SrTM <br />0 MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PER CT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRiDAY 8:00 AM+S:QQPM - EXCLUDING HOLIDAYS. <br />I. List up to ten addresses in the space above. Select the types) Of files from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0133 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 END 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 review. 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 some condition as released will be reorganized by EHD staff at the expense of the <br />annlinant. FLtrm fila reviews by the same aoDiicant may require a $93.00 deposit prior to review. <br />e� <br />1tivo5 <br />- . <br />•ra' a USE .NLY <br />Le A <br />Uim <br />mom <br />�1 lir <br />Specific Date Range of Information Requested: From A VVU to iAcywr�.T <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />IfUNDERGROUND TANK (UST) CLEANUP SITE (LOP) Q HOUSING ABATEMENT grSOLID WASTE FACIL"IVEHICLE <br />ryQ7M'� Eli CLEANUP SUE (NON -LOP) ❑FOOD FACILrry WWASTETIRE <br />IM UNDERGROUND TANK(MONRORMGIREMOVAL) 0DOG KENNEL Er DAIRY <br />R'HAi.AR0003 WASTE GENERATOR MCHICKEN RANCH [YWAGTEwATER TREATMENT PLAN` <br />• TIERED PERMITTED FActLnT O MOTEL[HOTEL fir PUMPER TRUCK/YARDICHEM TOILETS <br />O TATTOO/BODY PIERCING ❑ POOLISPA (4 LAND USE APPLICATION SrTM <br />0 MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PER CT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRiDAY 8:00 AM+S:QQPM - EXCLUDING HOLIDAYS. <br />I. List up to ten addresses in the space above. Select the types) Of files from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0133 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 END 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 review. 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 some condition as released will be reorganized by EHD staff at the expense of the <br />annlinant. FLtrm fila reviews by the same aoDiicant may require a $93.00 deposit prior to review. <br />e� <br />1tivo5 <br />