Laserfiche WebLink
10/22/2010 08:46 92574660— AEI CONSULTANTS PAGE 01/01 <br /> Rr" MflM SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENViRONMENTAL HEALTH DEPARTMENT <br /> w..i 2 2 2010 600 East Main St.Stockton, CA 95202-3029 <br /> EN`JIRUN►Gt Egg Hca f�phone:(209)468-3420 Fax, (209)464-0138 Web:www.sjgov.57J�E T <br /> SLICE- PUBLIC REWRDSSRE�.�A�E-1�PP-�#CA�`-IQNAPPLiCANT: 1 P. BUSINESS/AGENCY:_ <br /> ADDaESS: T a►'h l l'ld _ CITY/STATEOP: <br /> _WA l IJ <br /> PHONE(1): (O - PHONE(2): Ca25 Oto 6656 FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE; Time: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> d CHECK BOX TO EXPEDITE RE ST-$115 FEE(CASH OR CHECK ONLY)•REQUEST PROCESSED INS BUsfNESS DAYS <br /> SIGNATURE OF APPLICAN Yl - Sp I Qk U-f DATE_ (Ip f 2.z 11� <br /> Electronic Information: ❑List❑Map—Description: L <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name <br /> .City <br /> � <br /> Unit 1C' MYt' &WCf � UittTn1�i_ <br /> 2- C4S Fyt4'`� Y) <br /> 3 5O <br /> 02C/ 5 Unit2 <br /> ----— a. 6a �e <br /> S .wl rs17 f-S4rP i-- S Kt <br /> Unit 3 <br /> 7. <br /> SM01IM4 <br /> 8. <br /> 9. C7 Unit 5 <br /> 00, <br /> Specific Date Range of information Requested: From Oct—U-It 8 <br /> _ fo <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SiTE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILrTYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) D FOOD FACILITY WASTE TIRE <br /> ®UNDERGROUND TANK(MONfTORiNGIREMOVAL) E]DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH WASTF 4ATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY n MOTi UHOTEL PUMPERTRUCKIYARDICHF.MICAL TOILETS <br /> Ill TATTOOIBODY PIERCING ❑POOLISPA LAND USE APPLICATION SITES <br /> tit MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REviEw: MONDA -FRIDAY 8:00 ANi-5:00PM(EXCLUDING HOLIDAYS <br /> 1• n addrpssgIn the space above. Select the type(s)of files fr�m the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0 r mall to thg addr®ss in icated above. Address <br /> ranges will not be accepted-for additional assistance with file addresse#,contact the EHI). 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 f r review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of live 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 be reorganize by SHO staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$115 deposit prio)to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)46 3425. <br /> END USE ONLY <br /> EHD 0-06 <br /> a�zrros <br />