Laserfiche WebLink
RIVED : <br /> "'}'. . EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> OCT 216 ENVIRONMENTAL HEALTH DEPARTM 10 Ell <br /> 1: (2 East Hazelton Avenue, Stockton, CA b::: 6sjg 8C� <br /> ENVfRt1Al�IENTAL HEALTH Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd U <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> .APPLICANT: NIGII010S aldivar BUSINESS/AGENCY: <br /> ADDRESS: CITY/STATE/ZIP: <br /> PHONE (1): (I(g)a(?j— 3UjU PHONE (2): FAX OR E-MAIL: <br /> 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 BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> 1. List up to ten addresses in the space below. Select the type(s)of files from the list below 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.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The 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 application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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 $139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map— Description: <br /> Specific Date Range of Information Requested: From _ to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> UNDERGROUND TANK(UST) Street# Street Name City toil <br /> CLEANUP SITE(LOP) ,1(� (/,t1'�1 /�/)1') /1(` Lodi' <br /> /�/ ❑CONSUMER Ivry/ <br /> 1dOTHER CLEANUP SITE(NON-LOP) 1 I A,1 V I I LAI' l 1 �/ h� L V V 1 I 1 n <br /> E�I`HAZAROOUS WASTE In'VMN' <br /> T ED PERMITTED FACIUW 2 I I 1 Clh r-(,h ,\ TYY[A'r Loot('ABOVEGROUND TANK v 1 'V� V IIIJJJ 1 111 WWW I L/ V" <br /> IVUST (MONITORING/REMOVAL) I(� ❑PWS <br /> HAZARDOUS MATERIALS 3 2-10 VW Fine T�� Lodi <br /> 2SPILURELEASE RESPONSE <br /> WATER DUALITY <br /> $OLIO WASTE FACILITY/VEHICLE 4 <br /> ❑FOOD FACILITY <br /> ❑POOL/SPA SttE MRIGAnGN <br /> ❑DAIRY 6 <br /> ❑LAND USE APPLICATION SITES <br /> ❑SEPTIC PUMPER TRUCK/ ❑HGDSING <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> WASTEWATER TREATMENT PLANT CUPA <br /> ❑HOUSING ABATEMENT 7 <br /> MOTELMOTEL <br /> CHICKEN RANCH/DOG KENNEL CUPA-UST <br /> 8 <br /> ❑MEDICAL WASTE FACILITY <br /> ❑TATTOO/BODY PIERCING SOLID WASTE <br /> ❑WASTE TIRE g <br /> ❑COMPIAINT <br /> ❑OTHER(PLEASE SPECIFY): CCOUNTING <br /> 10 <br /> "'BOXED AREA•EHD USE ONLY"' <br /> ❑EReco!rdsprovided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br />