Laserfiche WebLink
RECOVED - <br /> @�C9paC�lJEHD LOG NUMBER <br /> SAN l� COUNTY <br /> �Q�� ' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> -. Telephone: (209}468-3420 Fax: (209)464-0138 web: rr�Jvr.s�gov.org/ehd <br /> ffl%mo g .AL _ P11BLIC RECORDS RELEASE APPLICATION <br /> PERUMSEMar-R2 <br /> APPLICANT: Margaret Gho€Isi BUSINESS/AGENCY: doslin Real Estate <br /> ADDRESS: 12645 Bentley St. CITYfSTATEt2IP: 1.lVater€ord,CA 95336 <br /> rnargaretghodsl§ <br /> PHONE(1:): 209-640-1955 PRONE(2): FAX€ R E-MAIL: gmaii.com <br /> Please allow 10 business days arena date of application. submittal for the records to beavailable. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> 171 <br /> GI�IEcK BOX TO EXPEDITE P,EOUEST- 130 FEE 10;ASH OR t Ht C 9 1L Y}-REQUEST:F i�00ESa�EG 1N 3 SUS=CvES a DAYS <br /> SIGNATURE OF APPLICANT /^ DATE <br /> Electronic Information: ❑List❑ Map-Description: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street# Street Name city <br /> 1. 347 E.Main Street Ripon j( �� <br /> ❑Unit 9 <br /> 2. <br /> 3. ❑Unit 2 <br /> 4, ❑Unit 2H <br /> $, 'RUnit3 62:1l4� <br /> 6• ❑Unit 3HIVI <br /> a` =e <br /> ti. 7. [I Unit 4 J <br /> 8. ❑SITE MITIGATION <br /> 3. <br /> Unit 5 <br /> —io-7 <br /> S is Date Rrrg of Infgrcrratican R �ugted: Frear to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NbFaGtBUriDTANK(U9T)CLEAN4IPSiTE( 0♦) _P�QTELIFlDIEL OSciIi7lM�aSTEFACLITYIItEHICLE <br /> OT14ER,CLEANUP SriE(KoN-LOP) i1 HouswG ABAT€IiERT El FOOD FACILITY <br /> UND olio 10 TANK(ltgON11T0 RII4Gf REu4VA III tjIAsTE TIRE ®DAIRY,POOLISPA <br /> A.SOVEGROUND TANK Q CIIICKEu RANCHf DcG KENNEL [I WASTEN1rATERTREATI�IER-T PLANT <br /> E]HA ARDOUS WASTE j_1.NIEDICALWASTE FACILITY E]PULAPERTRUGKIYARD;Ck€MICAL TOILETS <br /> n HAZARDOUS MATERIALS r~-r TATTOWBODY PIERC NG Q LAND USEAPPLICATJON SITES <br /> IT T <br /> El TIERED PERIAED FACILITY 0 COWLAINTJRESPoKsE RECORDS 171 OTI ER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PEWT RECORDS ARE AVAILABLE FOR REAM': MONDAY-FRIDAY 6=AR:-5:(IQPI'A(E=LUDIF10 HOLIDAYS). <br /> 1. List up to tan.addresses in the space above. Select the types)of files from the listaboue by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2019)464-4138 or mail to the address indicated above._ Address <br /> ranges will not be accepted.Applications rseeivCd after 3:00 pm will be processed the next business day. <br /> 2, For assistance,In Identifying the nature.and content of 5-HO records,please contact END 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 a:pplicatfon. 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 raorgarfted by EHID staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. <br /> `I'SOXED AREA-EHO USE QNLYII' <br /> - <br /> ec <br />