Laserfiche WebLink
` ,DATE RECEIVED I=MO LOG NUMBER SAN .1(3AQCJIN COUNTY <br /> � °�" ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Dain St. Stockton, CA 95202-3029 <br /> 'L3Telephone- (209)468-3420 Fax: (209)464-0138 Web: www,sjgov.org/ehd <br /> n1 4',�.tirit'� <br /> FIL <br /> 'Et4 r�'J"-1-s PUBLIC RECORDS RELEASE APPLICATION � <br /> APPLICANT: �'�� Ro <br /> re vi BUSINESS/AGENCY: pnyloLll,r ���Pi_� LSI 1P, <br /> ADDRESS: 00, c%t/rrllJr., / / �/W <br /> c� � _ + (�2. CIT'Y/STATE/ZIP: , �c�c�an�r��b /��/ ��p l� <br /> PHONE (1): �J(a� � --�poQ PH0NI-(2): � (�2- FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: I�Vt---111 Time: <br /> (Pleas$allow 10 business days from date of aplAcation submittal-`Tentativo only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(C AOR G CK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ,�_b/ � DATE 2/ <br /> Electronic Information: [] List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Stra$t# Street Name City Unit 1 <br /> �. X15 ✓ v W T" acv fiAo G� <br /> 7'1-VIYU "'w 6j% <br /> r <br /> 4. <br /> 2. >�yC'— \ ❑O nit 2 <br /> Z411 i Vak11-61-P._ /ii <br /> 4. 7 J r-��e_ t 9r! I OIYVt i' U IO 'Cl 312 unit 3 ` <br /> 5. <br /> 6. <br /> 1 <br /> unit a <br /> 7. `-S�J 1` rlip:� Q roa(4" 'u) S fqi l� <br /> ,21L <br /> 8. � r(t ove Iq 40!-eS',S _y Units <br /> 9• <br /> 10. A <br /> unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 'UNDERGROUND TANK(UST)CLFJIIVUP SITE(LOP) HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) FOOD FACILITY ASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) DOG KENNEL DAIRY <br /> ,UNDERGROUND <br /> WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ,TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARVICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ACOMPLAINT 12ECOROS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC HERMIT RECORDS ARE AVAILABLE FOR RmEw: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUD(NG HOLIDAYS) <br /> 1. List up to ton 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 now 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$125 deposit prior to review. <br /> Nir.j LH3ki,nNly <br /> EHD as-ae tv71t 1 <br /> ZB/ZB 119l7d ONI _1VHIN3SOd ddQN119 b06b8t6916 so :CT TTOZ/le/ZT <br />