Laserfiche WebLink
USL 'IN N0'6 b[Ob 'bl 'AON anvil paAiaaa� <br /> DRraC,,E V�]ED CHD LVb IVUMn CK <br /> SAN JOAQUIN COUNTY <br /> NOV 12 2014 ENVIRONMENTAL HEALTH DEPARTMENT 3 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 A _J <br /> ENVIRONMENTAL � ne: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> PERMITi9ERvi0ES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1\'W QAN_bH&Wk. BUSINESS/AGENCY: kA1�M r ZN4< <br /> ADDRESS: 51, /o P W aiep— AVG— CITY/STATE/ZIP: S r OGKf0N 'CA e'IV2-02- <br /> PHONE (1): I S, F17-F, W PHONE(2): FACSIMILE: 3Z2_-- VARA <br /> Please allow 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 /> ❑CHECK BOX TO EXPEDITE REQ E(CASH OR CHECK ONLY.)-REQUEST PROCESSEb 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 ❑Unit 1 <br /> 1, d N . Gi--WzADO Sr- �OCK-rON j j;i(e- <br /> 2. I I v✓� ❑Unit 2 <br /> 3, 11�� llfl7lt ��' <br /> 4 I _ Unit3 <br /> [7. ]Gnit4 <br /> Unit 5 <br /> g• I ���� <br /> 10, tdUnit s <br /> Specific Date Range of information Requeeted: Fromto ZO i <br /> HEA <br /> ENVIRONMENTAL LTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITY/VEHICLE <br /> 'OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ASGVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HA7ARDOUS WASTENAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY ❑POOLISPA ©LAND USE APPLICATION SITES <br /> ❑TATTOOISODY PIERCING JKCOMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00Pm(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 m it 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. )=or assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> '3. 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 flies 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 atthe expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. BOXED AREA-EHD U5E ONLY" <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> 08101114 <br /> END 4e-D6 <br /> TM /TM MHA 'nNT 9LZSZZ69ZG 75:71 VTOZ/ZT/ZT <br />