Laserfiche WebLink
EHD LOG NUMBER <br /> SAN .IOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 609600 East Main St. Stockton, CA 95202-3029 <br /> ephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org <br /> 4 <br /> �:- <br /> Pp; iF�V'� 5 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �LkE:6 j�Ay G j_&_& BUSINESS/AGENCY: Lyr <br /> ADDRESS: 3.So lb'iv":;; j fie. S'40_ '1 n CITY/STATE/ZIP: Sit_ NGS rA 15i,2-i}-, <br /> PHONE(1): q 2l'(. IE-IF 1 PHONE(2): FACSIMILE: Ci i • q 77, 3 70 <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- EE SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1//2C,/0�f <br /> Electronic Information: ❑ List ErMap—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> El Unit 1 <br /> 2. <br /> ❑Unit <br /> 3. <br /> 4. <br /> - ❑Unit 3 <br /> 6. <br /> 7 ❑Unit 4 <br /> ❑Unit 5 <br /> 9. i <br /> 10. <br /> /Un6 <br /> Specific Date Range of Information Requested: From to <br /> Ole <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILTTYtVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR PKCHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEUHOTEL <br /> ❑TATTOO/BODY PIERCING ❑POO ISPA ❑LAND U E APP CARO SITESHEMICTOILETS <br /> ❑ MEDICAL WASTE FACILITY LAND USE APPLICATION SITES <br /> ❑OTHER(PLEASES <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING 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 appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications 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 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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> , n <br /> EHD 48-06 <br /> 8/27/09 <br />