Laserfiche WebLink
Apr 1t&-0&-04A6p Drew Van Allu- 2(- 667-9668 p.1 <br /> Uti��JLg' ' U ' IIJ <br /> DATE RECEIVED EHD LOG NUMB <br /> �+���•� I -1') ?0,,�5 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> EPvViFiUIW/IEiN'[ 1;E/,!;( I 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION 17ZEF <br /> APPLICANT: D f-ttt4a A l <br /> t r BUSINESS/AGENCY: Aj>'_X <br /> ADDRESS:_Z V�-te t �rev� 7`� ;��(� `i 37 � e <br /> PHONE(11): (Lilo r� ��'}y PHONE(2): � ' b�� FACSIMttLE: �Q�Ql <br /> TENTATIVE*APPOINTMENT DATE: 5 3/05 Time: �t <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-`$93.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION ❑ Unit t ❑ Unit 2 ❑ U 3 Unit ❑ Unit 5 ❑ Unit 6 ❑ Other(electranlcllistslmaps) <br /> FILE ADDRESS OleEHD USE ONLY *#Y,2_ <br /> Street ay Street Nam *#re City te, <br /> Lr', I L Iv/ <br /> 2- 7-350 <br /> 3. ct 14 S <br /> 4. ( LtO G, H�,•�,,ucr ( tet S - ^ 3 a /b9 <br /> 6. 4tD(<, St l3(Vcl. <br /> 7. (5cj�I W, W <br /> s. z5co N. klti,•l 4 0 <br /> 9. O S . EI DGS Sre UC�L� s.} <br /> 10. 33-55 ,Li.s nro -\,J-,-. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACIUTYIVEHCLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑Fooc FAcIurY ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MOWTORNWREuoVAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHCKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑ PUMPER TRUCKNARDICHEM TOILETS <br /> ❑TATTOCIBODY PIERCING ❑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 <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 files 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 /> EFID 48-02-006 <br /> 111410S <br />