Laserfiche WebLink
° FMTI ��./ � EHp LOG NUMBER <br /> itD SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> OUT 3 0 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-342MFaX,, (209)4$4=0138 Web; www.sjgov,org/e <br /> ENVIRONMENT HEALTH 11 t7Z <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESS/AGENCY: <br /> ADDRESS: 'gA!5? CitylststelZlp <br /> PHONE(1): — PHONE(2); FACSIMILE: ` '� A��S <br /> TENTATIVE APPOINTMENT PATE: 4 U Time:_fes <br /> (Please allow 10 business days from date of appliettion submittal-'Tentative only-must be Confirmed) <br /> 13 CHECK BOX TO EXPEDITE REQUEST- E(CASH CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE U �4 <br /> Electronic Information: E]list❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1, 7 Q '� a Unit 1 <br /> 2 a 1t f1 ❑ Unit <br /> 3. a rt Jt Im tl It <br /> 4, <br /> !I►(t+ h ttt +l+I co tIttnu rlL1S <br /> (` <br /> ❑ Unl <br /> 5. <br /> ,0Unlt4 <br /> fl att <br /> 8. Unit 5 <br /> s. 9- <br /> \/ \ <br /> 10. Unit 6 <br /> 1. <br /> Specific tate Range of Inforrtmatlon Requested: From 111,4 to <br /> ` � ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> it UNDERGROUND TANK(UST)CLEANUP SITE(LOP) .0 HOUSING ABATEMENT 0 SOLID WASTE FACILfIYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 1'FOOD FACILITY ❑WASTE TIRE <br /> yITUNDERGROUND TANK(MONITORING/REMOVAL) 0 DOO KENNEL, ' "' t0 DAIRY <br /> !�HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH CD WASTEWATER TREATMENT PLANT <br /> El TIERED PERMITTED FACILITY 0 MOTEUHOTEL 11 PUMPEk TRUCKlYARDICHEM TOILETS <br /> MEDICAL ODYWAS PIERCING C3 POOLISPA ❑LAND USE APPLICATION SITES <br /> D MEDICAL WAsrt_FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WEU,AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:000 - EXCLUDING HOLIDAYS- <br /> 1. List up to ten addresses In the spare above. Select the types)of files from the list above bycheckingthe appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209 4§4-0138 or mai to the addr s indicate overAddress <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 EHD will notify the applicant if any EHD file]exist..An appolritrnent for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files'w)fl'be held fdr <br /> should be scheduled accordingly. a maximum of five business days for review, Appointments <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <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$105 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 46.06 6104/08 <br /> PUBLIC RECORDS RELEASE APP FORM <br />