Laserfiche WebLink
Mar 03 2010 1 : 42PM THE UPS STORE #2503 9167-151772 P, l <br /> EHD LOG NUMBER <br /> 11 i SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 800 East Main St. Stockton, CA 95202.3029 <br /> wr(209) 468-3420 Fax: (209) 464-0138 Web: ww,sjgov.org/ hd <br /> ENVIhl) Tigaphonla: <br /> L.l <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: _VIN j BUSINESS/AGENCY: J(n'.'_j ' <br /> ADDRESS; ��* "'G °~�'�h �� CITYISTATEIZIP:G.rA <br /> PHONE(1): crf� 3'r '2 13&&C-PHONE(2): FACSIMILE;_ � 26$ —.2 <br /> TENTAT WEI APPOINTMENT DATE: Time: . <br /> (PlloIaso allow 10 business days from date of appikation submittal-'Tern Wve only-must bo confinned) <br /> ❑c+ r, BflX TO EJ(PEDITE RE -S115 EE(CAS 0 CH K ONLY)-REQUEST PROCE88EO IN 3B <br /> 71N�rSDAYS <br /> SIGNATURE OF, APPLICANT DATE <br /> Electronic Inform tlon: ❑ List❑Map- Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Strost 9 StrW Name city El Unit 1 <br /> 2. Unit4 <br /> _ I p X <br /> 4. (� 1 <br /> _.__ Unit 3 <br /> 6. i r a — /Unit 4 <br /> 7. <br /> 8. <br /> ❑Unit 8 <br /> 9. <br /> 10, <br /> /Un It A <br /> Specific Date RangeInformatlan Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TAN (UST)CLEANUP SITE(LOP) ❑HOUSINOABATEMENT SOLID WASmFACL"IVEHICI,E <br /> OTHER CLEANUP SITE(NON-LDP) ❑FOOD FACILITY MARY <br /> ASTE TIRE <br /> NDERGROUND TANI (MONITORINWREMOVAI.) ❑DOG KENNEL <br /> A2ARDOU6 WASTE GENERATOR ❑CHICKEN RANCH ❑WwEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY MOTELIHOTEL ❑PUMPER TRUCYJYARDICHERCALT01LET8 <br /> ❑TATT00f80DY PIERC NG ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ <br /> MEDICAL WASTE F ILITY E]OTHER(PLEASE SPECIFY) <br /> WELL AND 811 ERMIT RECORDS ARE AVAILABLE FOR REVIEW. MONDAY-FRIDAY 8:00 AM-6.00PM(EXCLUDING HOLIDAYS) <br /> 1. List un to ten addresses In the space above. Select the type(*)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected, Fax to(2081484.01$8 or malt to the address IndlpfW0to(2081484-0138 or malt to the above. Address <br /> ranges will not 4 accepted-for additlonal assistance with file addresses,contact the EHD. Applicatl ons received after <br /> 3:00 pm will be Orocessed the next business day. <br /> 2. The IEHD will notify the applicant If any EHD flies exist. An appointment for revlow will be confirmed approximately ten(10) <br /> days after racet t of application. The file*will be hold for a maximum of five bushes*days for review. Appointmonts <br /> should be scheduled accordingly. <br /> 3, A fl lo that Is actively being vmrked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file is avalloble. <br /> 4. Any file not rete nod In the some condition a*reieaeed wilt be reorganized by EHD stuff at the expenee of the eppllcanL <br /> Future file revlorn by the same applicant may require a$118 deposit prior to review, <br /> 5. If you need further assistance,please contact Diana Martlnaz,at(209)468.3426. <br /> !H D USE ONLY <br /> EHD to-o6 <br /> smroa <br />