Laserfiche WebLink
01/27/2011 12:25 20933'18303 LODI DOWNSTAIRS PAGE 02/02 <br /> C EHD LOG NUMBER <br /> Rr rfty SAN JOAQUIN COUNTY <br /> ZO„ ENVIRONMENTAL HEALTH DEPARTMENT ,w�� <br /> 600 East Main Street, Stockton, CA 95202-3029 g <br /> Telephone; (209)468-3420 Fax: (209)464-0138 Web: vVvvvv.sjgov.org/ehd <br /> ENVIRONMENTAL <br /> LTH <br /> RM IT/SERV ICES <br /> P <br /> Tina <br /> RECORDS RELEASE APPLICATION <br /> APPLICANT: Cheney BUSINESSIAGENCY: <br /> ADDRESS: 902 IndUstra(aLWay Cityistateizip LIr CA 95 40 <br /> PHONE(1): 7nq-747-0640 PHONE(2): FACSIMILE: 7Si-L Z3�-S30� <br /> TENTATIVE*APPOINTMENT DATE: Please tali Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _ DATE 1-28-11 <br /> Electronic Information: List❑ Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name _ City <br /> Unlf 1 <br /> _�- 4051 Newton Road Stockton h <br /> 2. 3931 Newton Road Stockton / 2 <br /> _3_ 4105 N._Wilson Wa .....Stockton <br /> . <br /> � <br /> 4. •--- unit a <br /> 5. <br /> Unit A <br /> 6. <br /> 7. ,,. ...-_ Unit 5 <br /> 8.- <br /> g• ❑ Unite <br /> Specific Date Range of Information Requested:From to <br /> >( <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> >(UNDERGROUND TANK(UST)CLEANUP SITU(LOP) ❑HOUSING ADATEMENT ❑ SOLID WASTE FACILITYNEHICLE <br /> *OTHER CLEANUP SITE(NON^LOP) 0 FOOD FACILITY 17 WASTE TIRE <br /> YXUNDERGROUND TANK(MONITORINGIREMOVAL)X 0 DOG KENNEL 0 DAIRY _ -7 1 <br /> ,ter HAZARDOUS WASTE GENERATOPV-' 0CHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> 17 TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARD/CHEM TOILETS <br /> •TATTOOIBODY PIERCING 0 POOUSPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY M OTHER(PLEASF.SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY,FRIDAY 8:00 AM-5:00PM -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Faxto Iz091464-0138 or mail to the a 1068 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 he 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 business days for review. 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 he reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> EHD USE ONLY <br /> S 1 <br /> $75 d IN <br /> EHD 40.06 9104108 PUBLIC RECORDS RELEASE APP FORM <br />