Laserfiche WebLink
OG/17/2012 ®21: 3 888444308 PEM • PAGE 01/01 <br /> IM _ <br /> IV EHD LOG NUMDER <br /> 10 SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> )COAO 600 East Main St. Stockton, CA 9520'2-30'29 <br /> �S P,,V�'¢phone: (209) 466-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPL,ICATIO <br /> r�y71 _ <br /> APPLICANT: �IVU� �S BU91NE88/AGENCY: ��I )� t2C <br /> ADDRESS: �� I ( 2YIYISTATEIZIP ��( G�}Ytti�% i/ J <br /> PHONE (1) / 7r'`� PHONE(2): 7 ILE: <br /> T ATI 'APPOINTMENT DATE: Time: r7 <br /> (Please allow 10 business day m date of appliratlon Riebmirfal-'Tentative only-must bo confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQU T• 12 EE SH R H ONLY)•REQUEST PROCESSED IN 3 SUSIN DAYS <br /> SIGNATURE OF APPLICANT DATE Z- <br /> Electronic Information: ❑ Listin Map-Description: 41 <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Na/me City ❑unit 1 <br /> 7 2i T V-s- ( r I <br /> 22. 4{ 2 /� . vl 4 -F v� -- � .__ .o'bn1f2_ <br /> 3. _ T1-( Ve- <br /> 4. .� ZsjZ �Or/✓lC� J �/ nh3 <br /> 6. O® Can✓ 2D 2i Unita <br /> 7 <br /> S. ❑Unit D <br /> 9. <br /> 10. unit e <br /> Specific Data Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> (��IJNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Ld SOLID WASTE FACILRYNEHICLE <br /> [OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTETIRE <br /> r-- UNDERGROUND TANK(MONITORINGIREMOVAL) n DOG KENNEL ❑DAIRY <br /> u,HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKNAROICHEMICAL TOILETS <br /> ❑TATTOOMODYIPICtICINr ❑POOLISPA ❑LAND�USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY [I OTHER(PLEASE SPECIFY) UUtJL( (L'rj-j U <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOuclAYS) <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(els). At least one file type MUST be sgfected. Fax to(2091464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addreaaea,reintart the FHD. Applications received after <br /> 3:00 pm 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 ton (10) <br /> days after receipt of application. The files will be held for a maximum of five bupinoee days for roview. 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 application 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 filo mvlews by tho same applicant may require a$122 deposit prior to review. <br /> EHD use on�v <br /> 07/29110 <br /> EHD 48.09 <br /> Received Time Jun. 17, 2012 10:44PM No, 0253 <br />