Laserfiche WebLink
DATE RECEIVED EI-IO LOG N B <br /> SAN JOAQUIN COUNTY <br /> RECEIVE(. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> Kc_3 14 ?o(? Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/eh <br /> ENVIRONMENTALjCHEALTH <br /> PERA4IT/SERVI , PUBLIC RECORDS RELEASE APPLICATION <br /> _/� <br /> APPLICANT: G <br /> c]I yac,` G n acp'yi(^ <br /> G BUSINESS/AGENCY: �+U ~'O <br /> ADDRESS: p L/ �(�'I Mo Aye- cITYISTATE/zIP: I'OU <br /> PHONE(1): ZODi 11?? 4 J(tA PHONE(2):7.00I 321 'LLbj FACSI L,M E da8� 2�q . 264t� <br /> TENTATIVE`APPOINTMENT DATE: 2-2g 1L Time: 9:10 <br /> (Please allow 10 business days from date of appllw6on submittal-"Tentative only,must be confirmed) <br /> Q CHECK BOX TO EXPEDITE REQUE+ 5125 FEE RSH OR CHECK ONLY)-REQUEST PROCES5ED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT O A vDATE_ <br /> Electronic Information: ❑List'EA21p-Description: <br /> FILE ADDRESS END USE ONLY •,// <br /> Strom# Street Name City � vim-1-0 unit <br /> 1AOBS 1 S /� r �k)iow /Ra• Tracy >�ii}.c ;'otl8/ cpt6l! <br /> 2• 2 U q 7' r (I uI 'Ir�• Unit2 <br /> 3. <br /> 4. rY1S- R2• !il Unita <br /> 5• Ota] S. Q'H 41'f ��, 55 <br /> Unit 4 <br /> 7. ,:=i_ . . <br /> ❑Units <br /> 105 °i <br /> _ nR a <br /> lnformatlonFte9uestad: From 1°o.r reiF to �J•C,Pcn�- <br /> Y• ENVIRONMENTAL HEALTH DEPARTMENT FILES - <br /> y`hIINOERGRoOND TOR(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT �ti000 WASTE FACICITYNEHICLE, <br /> FEl CLEANUP SITE(NON-LOP) FOOD FACILITY 1544NASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL [-IDAIRY <br /> AZARDOUS WASTE GENERATOR [j CHICKEN RANCH RNASTLWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELMOTEL ❑CumpeR TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOIJSPA MIAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑COMPLAINT RECORDS Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(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 /> b'ox(es). At least one file type MUST be selected. Fax to(2091464.0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. Applications received after <br /> *0 pm will be processed the next business day. <br /> 2. Tfte END.will.riptify 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 /> shopld.be.scheduled accordingly. <br /> 3r A fia that Is actively being worked on by END staff may not be immediately available for review. A new application may be <br /> s bmitted wheh the Nle Is available. <br /> 4 j� il6nis-4rreturned in the.same.condition as released will be reorganized by END staff at the expense of the applicant. <br /> ,F.uttire_file.reviews by the same applicant may require a$125 deposit prior to review. <br /> - - fi14' ENG USE GNLV <br /> aHa:kB•96•.:2.. `. 'r, :6i 911111 <br /> TA 39vc! N0dRJ039N3 96LTGGSGQZ TT :ZT ZT9Z/bT/Z0 <br />