Laserfiche WebLink
Sep-20-07 04:20pm From-ENVIRON +5106559517 T-430 P.02/02 F-008 <br /> rrnv i.v�ivuwiwtii. <br /> PATE �, �. SAN JOAQUIN COUNTY <br /> `���� `�11D�'l ]ENVIRONMENTAL HEALTH DEPARTMEN <br /> Ar <br /> F '04�p 600 East Main Street, Stockton, CA 95202-3029 <br /> 0 elephone: (209)468-3420 Fax- (209)4640138'Web:www.sjgov h <br /> 33 <br /> EhJViRC'�nitfu rriERLl <br /> Ji'M r, E c �UBLIC RECORDS RELEASE APPLICATION <br /> I <br /> APPLICANT:S`/1Gam. py1��A„lrl V.1Ay1dV.P'nBUSINESSIAGENCY: NV R0� <br /> ADDRESS: ��h <br /> PHONE(1)-15� - PHONE(2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: LA 0 o u 61'LOD �Tl�►� i � a��(,t Ct�Ip(t?� <br /> (Please allow 10 business days from date of application submittal-'7ontative only-must be confirmed) <br /> 0 CHECK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASHOR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT A( (__ , DATE UO <br /> Electronic information: Q List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name - City ❑ Unit 1 <br /> F3. _(�� <br /> IJl Gu'k P k` � �r��.,�_ -�U 2 ✓vr ElUnit2 <br /> - Unit 3 \\ <br /> 4. Olt <br /> 5- I Unit 4 <br /> 6. <br /> T. ❑ unit 5 <br /> g, Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested:From u. c���( �Gt Z to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING ASATEMENT SOLID Wkini FACIUTYNEHCLE <br /> THER CLEANUP SITE(NON-LOP) M FOOD FACILITY M WASTE TIRE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) CI DOG KENNEL C3 DAIRY <br /> AYARDOUs WASTE GENERATOR O CHICKEN RANCH Y-WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTEL/HOYEL ''D PUMPER TRUCK/YARD/CHEM ToILEYS <br /> 13 TATT0019oDYPIERCING 0 PoOLISPA `1 /1C7 U1 o�Sj APPLICArr SI1TE,S <br /> ❑MEDICAL WASTE FACILITY �PTHER(PLEASE SPECIFY) INP \l 1/�V'%V 117 Yyylk-y' <br /> WELL AND SEPTIC PERMrr RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 5:00 AM-5'DUPM - 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 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 FHD 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 new app Icat on ma — <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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> E 49.06 WEB Bid/ 07 <br />