Laserfiche WebLink
Jun 07 2010 7: 399AM 1 UPS STORE #2503 916 1772 P. 1 <br /> RLIt .I \�r� L FHD 1,00 NUMBER <br /> SAN JOAQUIN COUNTY <br /> j;�N Q 7 ZU10 ENVIRONMENTAL HEALTH DEPARTMENT <br /> E(�lViRG � IEI�T �, 600 East Main St. Stockton,CA 95202-3029 <br /> �RV-1 p One: (2C9)466-3420 f=ax: (209)4640138 Web: www.sjgov.or <br /> 5 <br /> FERMlTf _ PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ( BUSINESSIAGENCY: <br /> ` v CITISTAYIP: C C <br /> ADDRESS; <br /> PHONE(1): �jl �'7- g�G�� PHONE(2): f —7C, FACSIMILE: �/� •Z�$�_g�s_�� r <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please anew 10 busineas days from data of application submittal-'Tantadva only-must ba confirmed) <br /> �] CHECK BOX TO EXPEDITE REQUEST-$1 15 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic InformationList❑Map-Description: <br /> ADDRESS EHD USE ONLY <br /> Sit* 9traat Nam* City ,_ Unlit 1 <br /> ❑ Unit 2 , <br /> 3. <br /> 4. Unit 3 i <br /> g Unit 4 <br /> 7. <br /> 8 __ ❑Unit 6 <br /> 9. <br /> 10, Untt e <br /> specific Date RaNe of information Raqueotad: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FLES <br /> 0ADEROROUNDTANK(I.IST)CLEpMP SITE(LOP) [I HOUSING ABATEMENT ❑SOLID WASTE FACtLITYIYEHK:LE <br /> HER CLEANUP 139E(NON-LOP) ❑FOOD FACILITY Q WASTE T1RE <br /> DERGROUND TANK(MON ITORINGIREMOVAL) 71 DOG KENNEL ❑DAIRY <br /> ZARDOUS WASTE GENERATOR CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERmFuEc FACILITY g MOTELIHOTEL ❑PUMPER TRUCKIYARMHEMICALTOdLEfs <br /> ❑TATTOCISCDY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> F-1 MEDICAL WASTE FACILITY Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRJDA,f S;00 AM-6:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List Up to tort addressee In the apace above. Select the type(s)of fllee from the'ist above by chocking this appropriate <br /> box(es). At least one file type MUST be selected. Fox t4(209)40-011 2[stall 10 the addroos Ind}cstad+abave. Address <br /> ranges will not bo accepted-for additional assistance with file sddreases,contact the EHD. Applicatlons recelyed after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applloant If any i=HP t11es exist. An appotntmentfor review will be confirmed approximately tan(10) <br /> days after receipt of applicotion. The files will be held for a maximum of five buslnass days for review. Appointment* <br /> should be scheduled accordingly. <br /> 3. A fila that Is actively being worked on by EHD staff may not bo Immediately oval able for review. A new application may be <br /> submittad when tie fila Is avallable. <br /> 4. Any file not returned In the aama condition as released will be roorganized by EHD staff at the expome of tine applicant <br /> Futuro file reviews by the same applicant may require a$115 deposit prior to ralJaw. <br /> 5. If you nand further assistance, please contact Diane Martinez,at(209)488-3425. <br /> Y <br /> I!HD[e-06 ei2rroe <br />