Laserfiche WebLink
12/06/2007 16:26 FAX 415 7659910 DIG Z001 <br /> jI/ I Fi� EHD LOG NUMBER <br /> Ll ll��� ti�y SAN JOAQUIN COUNTY <br /> 0 6 2007 ENVIRONMENTAL HEALTii DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> ENVIRONMENT HEALTH "f'elepilone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov. <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ` S BUSINESSIAGENNCYI: <br /> ADDRESS: Irl U fa V1 C I S C(0 [ 4 f <br /> PHONE(1)0 O(q 0C PHONE(2): f FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: ( 2- 11 //pz Tima: I 0; U Q am <br /> (Phase allow 10 business days from date of application submittal-'Ten(ative only-must bo confirmed) <br /> CHECK BOX TO EXPEDITE R�QST8.00 F (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � ; � DATE I��TO, <br /> Electronic Information: [] List❑Map--Description: <br /> FILE ADDRESS EHD USEONLY <br /> _ Street# Street Nama City ❑ Unit 1 <br /> A � <br /> 0 s n ,Y)rt AUPJ <br /> 2. Cxk� co n e - pC'r _ 1DL�I'w�`y► CJ Unit 2_ <br /> 3. ctA(A kIW-VV,2+ <br /> 4. Unit 3 t� <br /> 5. ❑ Unit 4 <br /> 6. <br /> 7• ❑ Unit 6 <br /> 9. ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested:From 1 -15 to '1(d4 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES J,��Z U��S <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) d HOU31N0 A13ATEMENT 1:1 SOLID WASTE FACILITYlVEHICLE �„ <br /> ID OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY CI �1'WASTE TIRE �ilz( <br /> ❑,J�J'NDERGROUND TANK(MONITORING/REMOVAL) ❑Doo KENNEL 0 DAIRY <br /> to rIAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH WASTEWATER TREATMENT PLANT 2 I <br /> 0 TIERED PERMITTED FACILITY El MOTEtIHOTEL 13 <br /> PUMPER TRUCK/YARDICHEM TOILETS • <br /> a TATTOO/BODY PIERCING C3POOIISPA M LAND U E APPLI TIOSITES <br /> MEDICAL WASTE FACILITY D-PO�VYHER(PLFASE SPECIFYud pi GV <br /> _ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW -MONDAY-FRIDAY SAO AM-6:00PM - EXCLUDING AOLIDAY3. <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 1209)464-01,38 or mail 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 /> 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 ten(10) <br /> days after receipt of application. The files will be held for a maximum of five I)Usiness days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EH0 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 file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 40-04 wee BBY'007 <br />