Laserfiche WebLink
01/07/2015 15:35 9253715915 GEOCON CONSULTANTS <br /> �3ATE RECEIVED �► EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL WEALTH DEPARTMENT <br /> 186&East Hazelton Avehuc, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax,: (2.09) 464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �.p,:p,.e% "j�Ui �t/� BUSINESS/AGENCY; ;�Cc,.c/ <br /> ADDRESS: -��/�G' �jt� Lf� ///�f.C,,( i"� /�_fl....._ vf�Dr� CITY/STATE/ZIP: ��i'✓�'b_ G-a�*Ju✓�. �/a.. <br /> PHONE_ (1): /� � ,cJ//� PHONE (2)- <br /> Please <br /> HONE (2):Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> CHECK @OX TO EXPEDITE REQUEST-5+1?5_13F �C,1S1 i Clf�CHFc;K ONLY) RF_QUF_51 PROCESSED IN S BUSINESS BAYS <br /> SIGNATURE OF APPLICANT—��'J -'-z- ••'A DATE <br /> Electronic Information: ❑ Llst p-Dcs-Gpvon: <br /> FILE ADDRESS EHD USE ONLY <br /> Siren[7l Street Narno City ❑ unit 1 <br /> El Unit <br /> 3, / /-Q /If <br /> 7 U n It 3 <br /> G"?�y/� <br /> 6, !' d��I" -I....-.-. �Z�/� ❑UnIt4 <br /> 7. <br /> S. 0 Unit5 <br /> 10. ❑ Unit 6 <br /> Spn,Ifir.Dri n Rnngo of Inform�tlan Roqussted: From to <br /> ENVIRONMENTAL HEALTH D9PARTMENT FILES <br /> ^2l1NDERGROUND TANK(UST)CLEANUP SITE(LOP) Ei MEDICAL WASTE FACILITY SOLID WASTE FACILITY/VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT [ WASTETiRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> AaOVFGROUND TANK LJ CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> H.A7_ARDOUS-WAST[Il IA7-ARDOUS MATERIALS Ij MOTELIHOTEL PUMPER TRUCKIYARAICWEMICAI.TOILETS <br /> TIERED PERMIT T ED FACILITY ❑POOLISPA ❑LAND USF APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING _ C]COMPLAINT/RFSPDNSE RECORDS r]OTHER(PLEASE SPECIPY) <br /> �` ��AND SEPT1C PERMIT RECORD ARE AVAILABLE FOR REVIEW: 11110NDAY-FRIDAY 8:00 Aryl-5:OOPM(EXCLUDING HOLIDAYS} <br /> 1. L.Ist up to ten addresses In the space above. Select the tyfse(s}-rrF-flte�from the Ilsiabovc by checking the appropriate <br /> hox(es). At least one file type MUST be selcctr'd. F��io 12041464-0136�r m»Il to the a�ldress�ndlcs�ted above._ Address <br /> ranges will not he accepted.Appilcatlons rece;vr.d a#ar_3�Qo,_pm..wilLlat�procecsed the next busines6 day. <br /> 2. For assistance In identifying the nature and content of EHD records,please contact EHD at the number noted shove. <br /> 3. Tho 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 appliertion. The files wlil be hold fora maximum of five business dsiys for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any filo not returned in the same condition as released will be reorganized by EHD staff at the expenRe of the applicant. <br /> Future file rcvlcws bythe same applicant may require A $125 deposit prior to review. "*BOXED AREA-EHD USE ONLY"' <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> e <br /> 4120117HD 0.0 <br /> Received Time Jan, 7. 2015 2:43PM No. 7851 <br />