Laserfiche WebLink
Jan 119 01 1 U:11 a Apex - 20P 667-9668 p.1 <br /> R=@VE 0 <br /> SAN J•OAQUIN,COUNTY EHD LOG NUMBER <br /> JAN 2 9 2007 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENT HEALTH304 East Weber Avenue,3'd Floor, Stockton, CA 95202-2708 *7 :Z7Z <br /> PERMIT/SERVICES Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC. 11kRECORDS RELEASE APPLICATION <br /> APPUCANT: l-�1 <br /> ew D ravl ^ <br /> ADDRESS: 3L•ILK- M. Cn�(c�.,n –BUSINESS/AGENCY. ✓- iD�Y <br /> S4.,,k Blt�. S,30+e G 711,j,r[4cK cA T5Y67. <br /> PHONE(1): Z�`i �oCa'� - cnSO PHONE(2): Z�`) ��`e- Z t�-S Z- FACSIMILE: ct 66�- 6 rot°1 <br /> TENTATIVE"APPOINTMENT DATE: '2J):' T%07- Time: O�p� <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REUEST- 93/.00 FEE CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3)BUST ESS DAYS <br /> SIGNATURE OF APPLICANT Tkm V DATE ►1Z� p` <br /> UNIT DISTRIBUTION d Unit 1 0 Unit 2 ❑ Unit 3• D Unit 4 ❑ Unit 5 D Unit 6 ❑ Other(electronieAistsimaps) <br /> FILE ADDRESS <br /> Street# Street Name city EHD USE ONLY <br /> uqK s . 5+.mK 7 <br /> 2. Z 355 N_ ( 71 p - <br /> 3. G. cx A o <br /> 4. 1`?2sC. u <br /> 5. Zy `i La�✓�1 S $ Kron `�\ <br /> 6. <br /> 7. <br /> 10. <br /> Specific Date Range of Information Requested: From y Zd�� to C_,_3V f -40-, <br /> �,,� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGRome TANK(UST)CLEANUP SITE(LOP) D HOUsiNG ABATEMENT D SOLID WASTE FACIUTYNEHICLE <br /> 13 OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY D WASTE TIRE <br /> 10 UNDERGROUND TANK(M0NnDRINGJREM0VAL) ❑DOG KENNEL M DAIRY <br /> 0 HAzARDous WASTE GENERATOR O CHICKEN RANCH 10 WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTa- 0 PUMPER TRUCKiYARDICHEM TOILETS <br /> Q TATTOOISODY PIERCING 0 POOLISPA ❑LAND USEAPPucATION SITES <br /> D MEDICAL WASTE FACILITY D OTHER(PLEASE SPECIFY} <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 Am-5:00PM - ExCLUDiNG HOUDAYs. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted--for additional assistance with file addresses,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 flies will be held for a maximum of five business <br /> days for review. Appointments 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 <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 /> EH D 48-02-006 <br /> 7lt4105 <br />