Laserfiche WebLink
vwf �ff4vvo 1vz iv: vc rxa I�QQ1/441 <br /> z <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,'Stackton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.Org, <br /> *, <br /> y PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kt A i e— L o r_ VLQ r- BUSINESSIAGENCY_ rc7 S t IT SSC7 C f Ct }� <br /> ADDRESS: '6/L,1,0 l ❑ (amp DL'v . # 166 <br /> �l✓G c Mme.- � S(E 7�1 <br /> PHONE(1):. {F " ! PHbNE(2): FACSIMILE: <br /> -Lt4,It TENTATiVE*APPOINTMEENT DATE:-_ ! �/ �.], Tim@: <br /> (Please allow ton business days from date of applipatien submittal-'Tenfative only-must be can msd) <br /> CHECK BOX TO EXPEDITE REQUEST-$98. CASH OR CHE )-REQUEST.PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _ �C C ' � Y_ — DATE __- 5r 2 I0 <br /> Electronic Information: List.[] Map-Description: r_PP— )z IMC4 y� <br /> FILE=ADDRESS EMD USE ONLY <br /> Street# StreetNamc City, ❑unit <br /> 2( 15 1�11• rr i�-� Load _ >re�rr A1: , <br /> 2. C. 5 1 v -g '� <br /> 7'rrzG �1�3 oy1l� ❑Unit 2 . <br /> 3' o� Q . „ i I TQC tit /{fo .C- <br /> 4• 2 x4 5 p C1 `,� �`C'� �.C/� Tr ( �! 7r^2-lam �2 / mita <br /> 1-hW C�IFA K4 ;rtz 1.2ond rrcz a *.;On <br /> \ <br /> _... D <br /> 6.. 2 55 rrcL c <br /> 7 � -- ru vi L i /zea JL 7�rGr its a dc3a3 <br /> Cid Tr61 efS 7(o o 15Q5 ❑units <br /> LV &4-K LLEIAC. (Z acrd rrcL r Ct S3Gy_ d <br /> 1©. nit 6 <br /> I_ <br /> Specific Date Range of Information Requested:From to <br />�I ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> h Jy UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT .-XTSQUO WASTE FACRnY/VEH[CLE <br /> OTHER CLEANUP SrM(NON-LOP) la FOOb FACILITY 9WASTE TIRE <br /> f�UNDERGROUND TANK(MONITORINGIRGMOYAL) 0 DOG KENNEL 13 DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> C7 TIERED PERMITTED FACILITY ❑MOTEL►HOTEL C3 PUMPER TRUGKIYARDICHEM TOILETS <br /> ❑TATTOOIBODY PIERCING E3 PODLISPA O LAND USE APPLICATION SITES <br /> 11 MEDICAL WASTE FACILITY 0.OYHE.R(PLEASE SPECIFY) - <br /> I <br /> WELL AND SHPTIC PERMIT RECORDS ARE AYAILRBLE FOR REVIEW-MONOAY-kIDAY 800 AM-5,00PM - ExCLUDING HOLIDAYS. <br /> I. 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. Eax_to(209)464-0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 300 pm will <br /> i' 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 <br />'I 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. Afile that is actively being worked on by the EHD staff may not be immediately available for review.-A new application <br /> may be submitted when the file is available. <br /> 4, Any the not returned In the same condition as released will be reorganized by EHD staff at-the expense of the applicant <br /> suture file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD't3SE ONLY <br /> I Flip 4R-06 101291p7 PUBLIC RECORDS RELEASE APP FORM <br />