Laserfiche WebLink
12/26/2012 15:57 8052399 SIERRA DELTA CLT PAGE 01/01 <br /> DATE RECEIVED g SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> RECE��j ED ENVIRONMENTAL HEALTH DEPARTMENT / 075 <br /> EPARTMENT / 07 / <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> DEC 2 6 2012 Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.,Sjgov.org/ehd <br /> LTH <br /> ENVC [SERMTERVICESY <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: q (V11�1�J�. BUSINESS/AGENCY: J Qwa IJp��u <br /> ADDRESS: 13s �lv<✓i.c.y-.t Avt- ±21 CITYISTATEIZIP: 1�61-t5 3%0 <br /> PHONE(1): 9 �{ �— PHONE(2): FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only.must be confirmad) <br /> ❑CHECK BOX TO EXPEDITE REOUE$T-$125 FE A R C�4t K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT t_O-M+-Sk 2roc.. DATE b �� <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS END USE ONLY <br /> Street X Street Name City Unit 1 <br /> 1• I }IAl, Pw-iSD to <br /> 2` 0 unit <br /> 3. <br /> 4. <br /> nit a <br /> S. Jo-c✓1 <br /> 6. <br /> nil& <br /> 7. <br /> 8. <br /> []Unit 5 <br /> 9, <br /> 10. <br /> UNta <br /> Specific Dna Range of Information Requested: From to <br /> ,� ENVIRONMENTAL HEALTH DEPARTMENT-FILES <br /> IJ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLIDWASTE FACR.RYNEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ElFOOD FACIL1rY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORLNGIREMOVAL) I—]Doc KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACIUIY ❑COMPLAINT RECORDS ❑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 typa(s)of files from the list above by checking the appropriate <br /> box(ea). At least one file type MUST be selected. Fax-to 1209)464-0138 or mail to the addmas indicated abave. Address <br /> ranges will not be accepted-for additional assistance with Ole addresses,contact the EHD. Applications received after <br /> 3:00 prn 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 tan(10) <br /> days after racelpt of application. The files will be held for a maximum Of Ove business days for review. Appointments <br /> should be schedufad accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new applloation 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 some applicant may require a$125 deposit prior to review, <br /> F..HD USE ONLY <br /> CNa A606 e 1 1 <br /> Received Tlme Dec. 26, 2012 2: 59PM No. 1958 <br />