Laserfiche WebLink
RECEIVED <br /> APR 0 9 2018 <br /> SAN ,J OAQ U IN Environmental Health Department <br /> • C O U N T Y ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE(A.PPLICATION <br /> PERMITISE V 43V3 <br /> SUBMIT BY EMAIL <br /> EHD LOG NUMBER: PP <br /> APPLICANT: 1V1L,SI IA'M.1 Qn BUSINESS/AGENCY: G . <br /> ADDRESS: �j 2. r�Vk�i Jwi e_it)O.?i CITY/STATEIZIP: Mccleiiian / rA4 is(052_ <br /> PHONE(1): PHONE(2): FAX OR E-MAIL: arl1.(Gila lkl ,i 0.ti1 <br /> Please allow 10 business days from date of application submittal for the records to be available e*a�co M <br /> Staff will contact typo arran p apgWptment She a�d time to review the requested re ords. <br /> SIGNATURE OF APPLICANT }�.( a i �.t'.f,(ll !4/I4 V�_ DATE s <br /> 1. List up to ten addresses In the space below. Ad ss ran ILL NOT be accepted. Select the type(s)o files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464.0138, mail to the <br /> address indicated below,or email to infoCdsicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <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 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. u <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. 1/�� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: List' Map—Description: <br /> Specific Date Range of Information Requested: From 2 to q 20 <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT (Specific y 9 p ) EHD USE ONLY <br /> FILES addresses only,address ran es will not be ecce tetl <br /> h Underground Tank(UST) Street M Street Name city <br /> Cleanup Site(LOP) Caxsurncnn <br /> • r`�j Other Cleanup Site(Nan-LOP) t (3$�� W 6y-Ant tArLe Qe1• Tra <br /> J� Hazardous Waste <br /> RIFT <br /> %Tiered Permitted Facility 2 <br /> pbovegmund Tank <br /> ,UST (Manionag/Removal) '1 II I� PWS <br /> Hazardous Materials a <br /> f,Zsplll/Release Response <br /> solid Waste Facility/Vehicle 4 I I I I Iw rsn Oue�m <br /> j,Paad Facility <br /> Pool I Spa bSrrE MITIGArW <br /> ,tpalry $ <br /> -Land Use Appllcmdon Sites <br /> Septic Pumper Truck/ ouswo <br /> 6 <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant <br /> CUPA <br /> J31.Housing Abatement 7 AST/HM/HW <br /> ra MotellHolel <br /> ,Chicken Ranch/Dog Kennel DfCUPA <br /> 6 <br /> ,Medical Waste Fac11Hy UST <br /> atloo/Body Piercing <br /> Waste Tiro9 SCUD WASTE <br /> ,KCcmplalnt <br /> Mother(Please Specify): E]Acom WING <br /> 10 <br /> *"BOXED AREA-EHD USE ONLY• <br /> • cl- 1 F wk-Ae NOD. 2 '„to r,,,a ot kekxyc1 . k2. <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 46-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 I www.sjcehd.com <br />