Laserfiche WebLink
/ 08/10/2011 1G;61T FAh` TREADR'ELL & ROLLO 0001 <br /> g. r EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> A1' o�t°�1 ENVIRONMENTAL HEALTH DEPARTMENT <br /> TH 600 East Main St. Stockton, CA 95202-3029 <br /> ONstoephone: (209)468-3420 Fax; (209)464-0138 Web; www.sjgov,org/ehd <br /> ENWY RECORDS RE <br /> PUBLIC R LEASE APPLICATION <br /> APPLICANT: p BUSINESS/AGENCY: <br /> ADDRESS: 5�S /Vlorl r.n per_ S - ls a0 CITY/STATEIZIP: S -) A q,11 I j <br /> PHONE(1): ( ci��- T l 6 PHONE(2); FACSIMILE: '((5-- <br /> TENTATIVE*APPOINTMENT DATE: Time: I( cL w, <br /> (Please allow 10 business days from date of applicatlon submittal-'Tentative only-must be confined) <br /> ❑CHECK BOX TO EXPEDITER ST CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE_J � <br /> Electronic Information: ❑ List❑Map-Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street# Street Name Clty ❑Unit 1 <br /> 7• Unit 2 <br /> 3. - <br /> 0 <br /> 4. Unit 3 <br /> 6• ,Unit 4 <br /> 7. <br /> $• ❑Units <br /> 9. <br /> 10. / Unit <br /> Specific Date Range of Information Requested: Krom — I l p rT to <br /> ENVIRONMENTAL HFALTH DEPARTMENT FILES ��yy <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT LTJ SOLID WASTE rACILITYIVEHICLE <br /> 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 ❑MOTEL/HOTEL PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING E]POOLISPA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE 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 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 /> 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 /> 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 /> EHO LISE ONLY <br /> EMD 46-06 07139/10 <br />