Laserfiche WebLink
i <br /> U VED _- EHD LOG NUMBER <br /> ��EIVE® --�-- -��-}} SAN �OAQUIN COUNTY <br /> EN) ONMENTAL HEALTH DEPARTMENT <br /> OCT 2 9 ZO1Q� 600 East Main St. Stockton, CA 95202-3029 .5p <br /> elephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orgle <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> pFRIUSITlCG -- <br /> APPLICANT: ED MACDANIEL BUSINESSIAGENCY: PARTNER ENGINEERING <br /> ADDRESS: 3210 GOUGH STREET##105 CITYISTATEIZIP:SAN FRANCISCO, CA 94123 <br /> PHONE (1): 415-240-3205 PHONE (2):__ FACSIMILE:415-707-2038 <br /> TENTATIVE*APPOINTMENT DATE. `J Time: <br /> (Please allow 10 business days from date of applicatiar aut)mitt//zi-"Tentative only-must be confirmed) <br /> F-1CHECKBOX TO EXPEDITE REQUEST-$1,_. . i P_=H OR .F FCK,QNLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> I� SIGNATURE OF APPLICANT DATE 10/27/2010 <br />'4 Electronic Information: ❑ List ❑ Map - Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> E] Unit 1 <br /> -- <br /> 35 <br /> 1. 80D MARINERS DR. STOCKTON <br /> 2, 3555 WEST HAMMER LANE STOCKTON j nit 2 ! rd <br /> 3• <br /> 4• nit 3 <br /> 5. <br /> 6. <br /> fnit <br /> 7. <br /> 8. <br /> 4 ❑ Unit 5 <br /> 9 <br /> t 10- nit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> i ®OTHER CLEANUP SITE(NON-LOP) ❑.FOOD FACILITY ®WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ®HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> I ❑TATTOO/BODY PIERCING ❑POOLISPA <br /> ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ®OTHER(PLEASE SPECIFY) WELLS(WATER&MONITORING)&SEPTIC <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW:' MONDAY-FRIDAY 8:00 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. Fax to.(209)464-0138 or mail to the address indicated above. Address <br /> i 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 /> 1, 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 be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a $122 deposit prior to review. <br /> I <br /> EHD USE ONLY <br /> I <br /> I EHD 48-06 <br /> f 07!29!10 <br />} <br />