Laserfiche WebLink
SAN J OAQUIN COUNTY' <br /> ENV�JNMENTAL HEALTH DEPART4 <br /> 304 East Weber Avenue, 3 Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:ww0(.sjgov.0rg1ehd f <br /> PUBLIC RECORDS-RELEASE APPLICATION <br /> APPLICANT: U AV Alk- S/ Al Cf A, BUSINESSIAGENCY: <br /> ADDRESS:' v ? ?Q I"1 s;a Q Oi--) C i <br /> PHONE(1): 2c�9 N `7 ` 9/73 PHONE(2): C9 " �G fs (i( FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: 11 Time: b <br /> (Please allow 10 business days from date of application submittal-•Tentative'only-must be confirmed) <br /> 1] CHECK BOX TO EXPEDITE REQUEST- 9a. 10 FEE(CAS HECK ONLY)l REQUEST PROCESSED IN 3 BUSINESS D YS t <br /> SIGNATURE OF APPLICANT f DATEoe <br /> 6 I ds <br /> UNI DiSTRIgUi70N °C3 Unit 2 Uni!3 EJii�Et '�f Unit 5 4 ❑ Unit 6 D Other(electroniNtistslmaps) <br /> i !I <br /> FILE ADDRESS EHD USE ONLY <br /> Street 9 Street Name City i I <br /> yeg <br /> 2. I <br /> 3. <br /> 4. <br /> �. II I •3 �r. r <br /> g, <br /> 7. II of= tZ: F <br /> 8. <br /> 9. I <br /> 10. i <br /> Specific Date Range of Information Requested:From �/t% �� to :2L 06 <br /> i ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> a <br /> 10 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT 13,SOLID WASTE FACKMIVEMCLE <br />' 1W OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY ; 17,WASTE TIRE <br /> JR UNDERGROUND TANK(MONITORINGIREmcyvAL) 17 DOG KENNEL I P DAIRY <br /> ❑HAzARDOUS WAsTE GENERATOR ❑C"ICKEN RANCH o WAsTmATER TREATMENT PLANT <br /> I ❑TIERED PERMITTED FACILITY 13 1416TELJHOTEL 'yft E!PUMPER MWYARDICHEM TOILETS <br /> TATTOQBODY PIERCING O POOLISPA �I. ❑LAND USE APPLICATION SITES = <br /> 0 MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) Il <br /> r WELL AND SEPTIC PERMIT RECORD$ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 A4-6:00P9 - EXCLUDING HOLIDAYS..- <br /> 1. List up to ten addresses in the space above. Select ther type(S)of files front the list above by checking the <br /> I appropriate box(es), At least one file type MUST be selected. Fax to(209)'464-0138 or_mai[to.the address <br /> Indicated above.. Address ranges will not be accepted--for additional assistance with file addressor,contact <br /> the EHD.Applications received after 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 � <br /> approximately ten(10)days after receipt of application. The files will be lietd for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. j <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be 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 <br /> applicant. Future file reviews by the same applicant may require a.93.00:!,deposit.prior to review. <br /> If n E I <br /> EHD 48-024f <br /> 11127/04 - <br /> �Il 4 <br />