Laserfiche WebLink
DATE RECEIVEOSAN JOAQUIN CCZE,90, ON W [ 910Z H 'a�WEamii`'palA I a� <br /> RECEIVES <br /> ENVIRONMENTAL HEALTH ®EPAR7-MENT <br /> 1868 East Hazelton Avenue, Stockton, CA 952056232 <br /> MAR 2 9 2 96 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web. www.sjgov. d <br /> �' NVIRONMENTALHEALTH PUBLIC RECORDS RELEASE APPLICATIOM <br /> APPLICANT.,-Leticia Martin BUSINESIVAGENCY: Y-11�ir)klAtx <br /> ADDRESS: 707 Wilshire Blvd. CITY/STATE/ZIP: Los Angeles CA. 90017 <br /> PHONE (l): 323-605-6639 PHONE(2): 213-596-6175 FAXOR E-MAIL: Lmartin@kleinfel.der.l <br /> Please alloy 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ,5.11E..,r^HE.....-I�. �..-1�•.,...�. ..._r r n..,y......,....r.......;,. ,,urp..y.. ' <br /> .......... .,.. ...,..,... , ........... <br /> Xr �CQA NE,t <br /> SIGNATURE OFAPPLICANT l <br /> ' <br /> DATE N'jn✓rl,. .l gl'.01(o <br /> Electronic Information: ❑ Llst❑ Map-Description: 711 <br /> FILE ADDRESS <br /> Street# Street Name Clgy EHD USE ONLY <br /> 1' 4221 E. Mariposa Stockton <br /> 2. E�u it 1 <br /> 3. <br /> lo 21Unit 2 <br /> 4. tJit <br /> t [] Unit 2H G0� <br /> 5. <br /> l'I ^/�nft 3 <br /> 6. <br /> Unit 3HR4 <br /> ❑Unit 4 <br /> Eg"8. <br /> SITE MITIGATION <br /> 9. t ' <br /> 10. �l J nit 5 <br /> Speelftc Date Range of Information Requasted: From <br /> . : to <br /> tdI1fIEr#dXp.,;�ISA' C.1 <br /> 9 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) NIOTELIfiOTEI '�SOLID WASTE FACILITYNEHICLE IQ <br /> ©OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT []FOOD FACILITY <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) 21 WASTE TIRE � 3 <br /> Q©AIRY,POOLIsPA <br /> Q ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL Q WASTEWATER TREATMENT PLANT <br /> [�HAZARDOUS WASTE [✓ MEDICAL WASTE FACILITY ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> Q HAZARDOUS MATERIALS ❑TATTOO/BODY PIERCING <br /> ❑LANE)USE APPLICATION SITES <br /> Q TIERED PERMITTED FACILITY � <br /> ©COMPLAINTIRESPONSE RECORDS [�OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of END records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any END 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 /> 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$130 deposit prior to review. <br /> ***BOXED AREA-E p USE ONLY*" <br /> d Records provided b_Staff-PPR Complete. Staff Nance. <br /> e° <br /> 1Z1-d 100/100'd 680-1 ZYZ61Z16Y6+ 83013AMN-11101d md9l:Zl 9102-6Z-80 �� <br /> o ® <br />