Laserfiche WebLink
\ SAN J OAQUIN COUNTY <br />�r �r . E O NMENTAL HEALTH DEPARTMor <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.or81ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: 11 N AV nim Iz- i S f Al C' M_ BUSINESSIAGENCY: <br />ADDRESS: G Sy? %I 1.0 /9 e et (- "Z-) C i d ,L' %e v7 C /') '9 S <br />PHONE (1): X1,`9—'1177 w Sl 13 PHONE (2): .1-69 4/-^ d 6 KS S FACSIMILE: <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - "Tentative only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST . 93 FEE (CAS K ONLY) - REQUEST PROCESSED'IN 3 B SINESS 0 <br />SIGNATURE OF APPLICANT _ HECK <br />DATE 1 0�- <br />t)Nrr DISTRIBUTION ' ` 3 Unit 2 9u ►it 3'JfUnit 4 ❑ Unit 5 ❑ Unit 6 ❑ Other (electronicAlsts/maps) <br />street # I Street Name <br />Q <br />El <br />Q <br />flfff i 7ZiWA <br />Specific Date Range of Information Requested: From , `l C/ (i to IL <br />06 S" 1 <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />10 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />❑ HOUSING ABATEMENT <br />0 OTHER CLEANUP SITE (NON -LOP) <br />❑ FOOD FACILITY <br />J3 UNDERGROUND TANK (MONITORINGIREMOVAL) <br />❑ DOG KENNEL <br />❑ HAZARDOUS WASTE GENERATOR <br />❑ CHICKEN RANCH <br />0 TIERED PERMITTED FACILITY <br />❑ MOTELMOTEL <br />0 TATTOO/BODY PIERCING <br />❑ POOLISPA <br />❑ MEDICAL WASTE FACILITY <br />❑ OTHER (PLEASE SPEC <br />Le <br />❑ SOLID WASTE FACILITYNEmcLE <br />❑ WASTE TIRE <br />Q DAIRY <br />❑ WASTEWATER TREATMENT PLANT <br />❑ PUMPER TRUCKIYARDICHEM TOILETS do <br />❑ LAND USE APPLICATION SITES <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 <br />DING HOLIDAYS. <br />1. List up to ten addresses in the space above. Select the. type(s) of files from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address <br />indicated above.. Address ranges will not be accepted — for additional assistance with file addresses, contactINMEw <br />the EHD. Applications received after 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 <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments 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 <br />application may be 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 <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit.prior to review. <br />EHD 4sa2-M <br />»mra4 <br />