Laserfiche WebLink
1YIN N. /. ZVVO 2:�Irm MOOR EARTH TECH <br /> IT[T <br /> NO. 5926 P. 2 <br /> SAIN JOAQLThN COUNTY EHD LOG NUMSER <br /> ?7 E1N7V1R0NMMN'rAL HEALTH DEPARTMENT <br /> I-EALTH <br /> ENVIRON,kil,E-1%1304 East Weber Avenue, 3d F100r, Stockton, CA 95202-2708 <br /> 1- I- <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/chd <br /> 7 <br /> -PUBL C RECORDS RELEASE APPLICATION <br /> APPLICANT: t44�'tr <br /> 7 <br /> eysm /AGENCY; <br /> ADDPEss; <br /> PHONE(1):ao PHONE(2): <br /> TENTATIVE*APPOINTMENT DATE-_ai Z�F FACSIMILE_ <br /> (Please allow 10 business days fromd <br /> ��Ocatlon submittal-"TeRtallyc only-must be confirmed) <br /> CHECK BOX TO EXPEDITE PE T.$93.0 FEE( CHECK ONLY)-REQUEST PROCESSED IN I EU (NESS DAYS <br /> -SIGNATUP,E OF APPLIC T <br /> DATE —N!7 10( <br /> EUNIT_0iSTRJBUTn1ON Ouniti 10junft2 OUnif Unita OUnits 17 Units 00ther(olactronicilist-,3/mapt) <br /> FILE ADDRESS <br /> Street# stm A Name ity EHD USE ONLY <br /> 1.2. 11 'D W <br /> 3. <br /> 4. <br /> s. <br /> rn e)P_ <br /> 0 <br /> 10. ,2p I <br /> Specific Date Range of Infonnation Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILfrY IrSILID VVASTU FAOILITYIVEHICLE <br /> ;PNOEROROUNO TANK(MONITORMVIRIMOIAL) 0 DOG KENNEL C1 WASTE TIRE <br /> HAZARDOUS WASTE GENERATORCl DAIRY <br /> TIERED PERMn 0 CHICKEN RANC:K <br /> TED FACILITY M MoTEL/HoTEL WASTEWATER TREATMENT PLANT <br /> TATTDOISODy PIERCING PUMPER TRUOKfYAPDjCHEM TC(LET3 <br /> MEDICAL WASTE FAaLITY 13 POOLISPA LAND USE APPLICATION SITES <br /> 1: <br /> OTHER(PLGAse SPECIFY) <br /> WELL AND SEP710 PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 6:00 AM_5. <br /> �n .00PM - ExCLUMNG HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list <br /> above by checking the <br /> appropriate bOX(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted—for adld_i­t�ionaj assistance with file addresses, contact <br /> the EHD.Applications received after 3:00 PITI will be processed the next business day. <br /> Z The EHD 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 nvvv <br /> application may be 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 <br /> applicant Future file reviews by the Same applicant may require a$93.00 deposit prior to review. <br /> EHD 4842-MG <br />