Laserfiche WebLink
From:Marcus H. Bole & Associs 530+633+0119 0 <br /> 121009 16:12 #140 P.001 <br /> EHD LOG NUMBER <br /> EDSAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 0 7 2009 600 East Main Street, Stockton, CA 95202-3029 <br /> ENVIRUNiV1tNT HEALTI lephone: (209)468-3420 Fax: (209)464-0138 Web:wwW.sj90v-O <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION ��++ <br /> �USINE.SSiAGEN'CY- <br /> BUSINESSIAGENCY. <br /> (_ <br /> APPLICANT: City/State/Zip <br /> ADDRESS: <br /> PHONE(2): '�U �` FACSIMILE: �n <br /> PHONE(1): _S<�i /Z _ p <br /> u•�S Time: <br /> TENTATIVE"APPOINTMENT DATE: - <br /> (Please allow 10 business days from date of application submittal- Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � ��T—� DATE <br /> Electronic Information: ❑List❑ Map-Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street# / Street Name City ❑ Unit 1 <br /> Z. Ila c7✓�J1._ �? ( 0 SAC6�� e r El Unit 2 <br /> 3. 3 \ <br /> 4. _ c.J/C /l/cC ., _1 // <br /> 7. -- nit 5 <br /> 8. <br /> Unit 6 <br /> 110. 11 Gc� C^err AQ <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Z UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT 121--s-OLID WASTE FACILITYNEHICLE <br /> W VTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY 0 WASTE TIRE <br /> Q lTERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL ❑DAIRY <br /> iAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY O MOTELIHOTEL 0 PUMPER TRUCKNARD/CHEM TOILETS <br /> 0 TATTOO/BODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 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(209)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$105 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 48.06 8,104108 _ <br />