Laserfiche WebLink
DATE RECEIVED H8 0 ' IN WV ` , 6 Z [ 06 '81 ' ( npsl•awil panlaaaa <br /> RECEIVED SAN JOAQUIN CoUlvl Y <br /> H ENVIRONMENTAL HEALTH DEPARTMENT <br /> I � <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> JUL 19 Z01Z Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wvrw.sjgov.orglehd <br />; i ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_ , f �7 Q S �7 BUSINESSIAGENCY: 1VQ svt <br /> SLiz ✓ t/JNri ¢n <br /> ADDRESS : LIbm CITY/STATEJZIP: W07eS-)V 4( 57,3Sg <br /> PHONE (l ): PHONE (2): FACSIMILE, z7 D5 . 357— <br /> TENTATIVE` APPOINTMENT DATE: July �O, 7�/� Time: 10 .40e 4,n <br /> (Please allow 10 business days from date of plica on submittal - 'Tentative only - must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST - $12 EE (C CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT G' DATE { h X1/2, <br /> Electronic Information: ❑ List ❑ Map m Descriptio : <br /> FILEADDRESS EHD USE ONLY ` <br /> Street # Street Name // ii-- C/i�tyL. El Unit 1 <br /> jw <br /> 2. <br /> ❑ unaz <br /> 3 -4-- <br /> Unit 3 <br /> 6" �S � 7-��®2 D76nit4 . <br /> 7. <br /> 8. <br /> ❑ unit s <br /> 9. <br /> 1o. <br /> ! El Units <br /> Specific Date Range of Information Requested: Fromi7 to ✓.ps A=., (- <br /> y-�. ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> )R UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITYNEHICLE <br /> [OTHER CLEANUP SITE (NONKLOP) ❑ FOOD FACILITY ❑ WASTE TIRE <br /> `C] UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> "HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHoTEL ❑ PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑ TATTooj airy PIERCING ❑ PDOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ COMPLAINT RECORDS ❑ OTHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8: OD AM-5: DOPM (E)(CLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Selectthe 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) 464-0738 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 $125 deposit prior to review. <br /> ::,n <br /> EHD 4e-06 - Stull <br /> 1, Id LZZZL9060Z uosleN eZZ: 60Z1, 841 <br />