Laserfiche WebLink
1b:28 San Joaquin County -> 4640.138 2 f <br /> J j= '� EHD LOG NUMBER <br /> ; EC11v pf_�i� SAN JOAQUIN COUNTY <br /> 1YEJ V 42 02-009 ENVIRONMENTAL HEALTH DEPARTMENT <br /> " 4z <br /> .. 600 East Main St, Stockton, CA 95202-3029 <br /> ��;i;`j� ;"i!; rp,i> ± pp i T�IeptTone: (209)468-3420 Fax: (209)464-0138 Web:www,sigov.org/e <br /> V+i(��;l�kt, iy, I 7L f <br /> I'� l� i+r'Mv` � PUBLIC RECORDS RELEASE APPLICATION l' <br /> .. <br /> APPLICANT: =�R.f, 'BUSINESS/AGENCY: 6_ 5; ..7��� <br /> ADDRESS: T, +! r� CITYISTATEIZIP: <br /> PHONE(1): (�2yq) 4-(a 'PHONE(2): FACSIMILE: Oil() q44- 5 ._S <br /> TENTATIVE'APPOINTMENT DATE: Time: IU <x� <br /> (Please allow 10 business days from data of application submittal•'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQVJEST-$115 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED.IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT N DATE Nov 1q, ,-vol <br /> Electronic information: ❑List❑Map-Description:. <br /> I FILE ADDRESS EHD USE ONLY <br /> Skreet# Street Namo A PN City E Unit 1 <br /> 1'. )705 Cotlr.lrk� CGccjet (L ,1 -.tlo..o SrocKrrarl n� <br /> 2. .2i3A L- YtiA�rpu.sH A.D,.. 173•o(,o-.15 T„c. e [3-Unit 2 <br /> 3• -:24-4-p <br /> 4. 7 ' G. hlw L5r?w0 h•.y, 1-or, r:For r> <br /> 6. 3s N. CNc.-0e6 LNn LoD! <br /> I ate, <br /> t 7.' <br /> B. p Unit 5 <br /> I 9, <br /> i <br /> 10. p Unit 6 <br /> d Specific Date Range of Information Requested: From _ I I I/:'eo6 to (' (A k.A E.AI T <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILDYNEHICLE t <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑Fool)FACILITY ❑WASTE TIRE <br /> " ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE OENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEL)HOTEL ❑PUMPER TRUCKIYARDIC HEMICAL TOILETS <br /> TATToo1$ODY PIERCING ❑POOLISAA ❑LAND USE APPLICATION SITES <br />° ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:0OPM(EXCLUDING HOLIDAYS) <br />#. 1, List up to ten addresses in the space above. Select the types)of files from the list above by checking the.appropriate <br /> t box(es). At least one fife type MUST be selected. Fax to(209)464•Q138 or mall 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 /> i 3:00 pm will be processed the next business day. <br /> 2. The EHD will notlfythe applicant If any EHD(Iles 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 appiicatlon may be <br /> j 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$115 deposit prior to review, <br /> b. If you need further assistance,please contact Dlane Martinez,at(209)468.3426. <br /> ENO US E ONLY <br /> EHD 48.46 8127149 <br />