Laserfiche WebLink
1004 J u1. 14. 2016 12 : 52PM No. 0894 P. I <br /> E-R(7EF <br /> I E 4 N; EHD LOG NUMBER <br /> �'Ij=D <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPA 'TM W4h <br /> C <br /> J U L 2 1868 East Hazelton Avenue, Stockton, A 9520" <br /> Telephone:(209)468-3420 Fax:(20 9)A64-0138 We b:WWV.dRous <br /> EMVERO(csMEE'Ni-541- PUBLIC RECORDS RELEASE APPLICATION <br /> t Ai�- <br /> APPLICANT: t Yrr-L GVe 'A_ BUSIN15SWAGENCY: — of roh^e;�Ta <br /> ADDRESS: CIT'OSTATE017: <br /> PHONE(2): FAY,OR-15'Mk- AnJt(., r-z- <br /> PHONE(fl: _3i0—_)-q7 4) , <br /> Please allow 10 business days from date of application submittal forthe records to be available. <br /> Staff VA contact you to arrange an appointment date and time to review the requested records. <br /> CHECK BOX TO EXPEDITE REQUUT-_PW FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE -7-t.4(— <br /> 1. <br /> I. List up to ton adc(resser,in the space below. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At feast one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm wilt be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD files eyist- An appointment for review will'I be confirmed approximately ten(10) <br /> days after receipt of application. The fifes will I be held fora maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned inthO Same Condition as released vvill be reorganized by EHD.staff, at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PIvii (EXCLUDING HOLIDAYS) <br /> Electronic Information' E] List L] Map—Description: <br /> Specific Date Range of Information Requested: From Af I to Ait I <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMIENT FiLE A DDRESS <br /> FILES EHD USE IONLY <br /> 'NrUNDFRGROUNO TANK(FST) Street 0 Street Name city <br /> _ <br /> CLEANUP SrrE(LOP) El <br /> L41s <br /> r 1A <br /> ,2 <br /> XOTHER CLEANUP SITE(NON-LOP) <br /> S. F_ CONSUMER <br /> HAZARDOUS WASTE El DAIW <br /> J;ZTiCAro PERMITTED FACILITY CIA- <br /> n(, <br /> �_fABOVEGROUNP TANK [3 PWTS <br /> �Z UST(MONITORING/REMOVAL) <br /> 19HAZARDOUS MATERIALS r::q 1 �'j. <br /> SPILLIR <br /> ELEA8E RESPONSE 7 <br /> ®NATER QUALITYSOLID WASTE FACILITY/VEHICLE 4 Duo A C_ <br /> F1 F�qoo FACILITY <br /> F1 POOL I SPA &I`fiITE MITIGATION <br /> E]DAIRY 6 <br /> LAND USE At-PLICATION SITES - [I Houalw) <br /> SEPTIC PUMPER TRUCK 1 6 <br /> YARD I CHEMICAL TOILETS <br /> 9WASTEWATER TREATMENT PLANT 8'CUFA <br /> HOU81NO ABATEMENT 7 <br /> MOTEUHOTIE L <br /> Ej CHICKEN RANCH/DOG KENNEL <br /> L]MEDICAL WASTE FACILITY <br /> E]TATTOOIBODY PIERCING <br /> AWASTE TIRE <br /> ACOMPLAINT <br /> 17 OTHER(PLEASE SPECIFY)-. [I AccovmnN <br /> 10 <br /> 50)(ED AREA-EHD USE ONLY-1 <br /> El Records provided by Staff-PPR Cornplete. Staff Name: <br /> Received Time:_-Jul, 14. -7'2016'_-12: 55PM-_'No, 0973 <br />