Laserfiche WebLink
0 0 <br /> RECTIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> 19 Z011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENViROMO;E\F�AL HEALTH <br /> PERM I-FlS ERVI CES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Ma CABUSINESS/AGENCY: Ael (6osQi-h:;(r%ts; <br /> 1j — <br /> ADDRESS: ysoo Qkwioo D1C4WO CITY/STATE/ZIP: VqalvN"a Qvee'w oft--a4sq? <br /> PHONE(1): (1-25 11'4- 191t 9 PHONE(2), FACSIMILE: (g2-());9 <br /> TENTATWE*APPOINTMENT DATE: 10jZ(' Time: <br /> (Please allow 10 business days from dote of application submittal-'Ye­ntative only-must be confirmed) <br /> SlCHECK BOX TO EXPEDITE REQUEST- 25 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINE$$DAYS <br /> ATURE OF APPLICANT DATE 1011112-1,111 <br /> Electronic Information: [I List Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street t� miStres,-t Name city /91, Unit I Ll-jt <br /> — <br /> 2. -2 2-Ly(z) Koer Ave' Sto C!Iie� o - <br /> E C� <br /> Z(Unit,2. <br /> 3. <br /> 4, <br /> UnIt3U <br /> U nit <br /> t-3 <br /> Unit 4 <br /> 7. <br /> 8.9. <br /> UnItS <br /> 10. E5"nit 6 <br /> Specific Date Range of Information Requested: From A to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) [IHOUSING ABATEMENT SOLID WASTE FACtLITYAfEWICLE <br /> OTHER CLEANUP SITE(NON-LOP) WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) Q DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR [3 CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY [3 MOTELIHOTEL PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> TATTOOIBODY PIERCING POOLISPA LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ton addrossgl In the space above, Select the tyPO(S)Of flle$from the list above by checking the appropriate <br /> box(se). At least one file type MUST be selected. FAX to(2221464-0136 or mail$9 lbaAftrass Indigalgd above. Address <br /> ranges will not be accepted-for additional assistance with fila addresses,contact the EHD. received after <br /> 3:00 pm will be processed the next business day. <br /> 2, 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 /> 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 ratumad in the same condition as released Will be reorganized by EHD staff at the expense of the applicant, <br /> Future file reviews by the Ume applicant may require a$125 deposit prior to review. <br /> FM L)C',[OMN <br /> EHD 41-00 <br /> T /T NV 9C:60 TTOZ'6T'qz>O <br />