Laserfiche WebLink
209-234--0538 Llne 1 16:03 05-06-2008 1 !I <br /> EHD LOG NUMPE-; <br /> DATE RECEIVED 9 SAN JOAQUIN COUNTY "e <br /> F,C uL� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> MAY 0 ; 2008 Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov,orgl , <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �d S( j? /"frac s�4 BUSINESSIAGENCY: <br /> ADDRESS: <br /> rHONE PHONE(2): FACSIMI E: <br /> TENTATIVE*APPOINTMENT DATE: Q 0 Q� Time: �� a <br /> (Please allow ten business days from date of allplication submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$98.0 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ Lis Map - Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name C ity <br /> �. <br /> ❑ n2 D ISV(Z- <br /> 2• <br /> Unit 3 \ <br /> 5. <br /> 6. it 4 J <br /> 7. <br /> 8. ❑Unit 5 <br /> 9. <br /> 10 Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT .SOLID WASTE FACILINNFHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITOR INGIREMOVAL) 0 DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR D CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATSOOIBODY PIERCING ❑ POOLISPA LAND USE APPLICATION SITES <br /> 11 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 6:00 AM-5:00Prh - 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 /> box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> 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 <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 the EHD staff may not be immediately available for review. A new application <br /> may be 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$96.00 deposit prior to review. <br /> EHD USE ONLY <br /> ­n AP.— 1nomw <br /> P I IRI('.PF(0PnR RFI FAAr GPA FOPM <br />