Laserfiche WebLink
06/03/2008 09:51 f"AX 5302431654 CH2H HILL 1a002/002 <br /> EHD LOG NUMBER <br /> DATE PSCEffED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT ..... -70 <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax" (209)4640138 Web,www.sjgo5e <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT.—tIgA SceK BUSINESSIAGENCy- CHi-AP101 <br /> ADDRESS: 5 Z Nrpgt� ()v- <br /> PHONE(l): PHONE(2): FACSIMILE- <br /> TENTATIVE*APPOINTMENT DATE: bjaLya Time-. 1,2ft <br /> (Please allow ton business days from'date of application submittal-"renrafive only-must be confirmed) <br /> 171 CHECK SOX TO EXPEDITE REQUEST-$99.00 FEF.(CASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Z DATE <br /> ,—11 <br /> Electronic Information: ❑List[I Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name Ed_y M unit I <br /> 1. I3H30 0or"47 <br /> 2. trtx� it 2 <br /> 3. <br /> 4. nit 3 <br /> —3_2 <br /> S. F-k E)Q'4"I10 <br /> S.Ilk Q>1 oA nit4 <br /> 7- -&yl <br /> units <br /> nit 6 <br /> Ave <br /> Ae . <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> d(UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACIUTY/VEHICLE <br /> UITHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 191WASTETIRE <br /> NDERGROUND TANK(MONrroRINc4REMOVAL) C3 DOG KENNEL 13 DAIRY <br /> AZAROOUS WASTE GENERATOR 0 CHICKEN RANCH C3 WASTEWATER TREATMENT PLANT <br /> 137 TIERED PERMITTED FACILITY 0 MOTEUHDTEL 0,PUMPER TRVCKfYARDICHEm TOILETS <br /> 11 TATTOOIBOoY Pja;IciNG MIPOOLISPA 'M LANE)USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 9 OTHER(PLEASE SPECIFY) NO!QAW& kp)Ae,�-C. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW-MONDAY-FRIDAY 8'00 AM-S;OQPM-EXCLUDING HOLIDAYS. <br /> 1. List up to ton addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EMD. Applications received after 3:00 pm will <br /> 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 <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 the EHD staff may not be immediately available for review. A new application <br /> 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 applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review, <br /> EHD USE ONLY <br /> EHD 46-06 10120107 PUBLIC RECORDS RELEASE APP FORM <br />