Laserfiche WebLink
DATE RECEIVED EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />Cll ),6ibq ,e/rim? ENVIRONMENTAL HEALTH DEPARTMENT <br />4_ fill 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />01- 'telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orgiehd <br />. <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: W ke,,P BUSINESS/AGENCY: <br />ADDRESS: ./-3„--7C.2 659)0116-6- ../e0/__5_. - 52>,,7E E CITY/STATE/ZIP:5;A--gg.oa/--/, ?_37941,/ <br />PHONE (1):1,2 67 0 PHONE (2):_72_ 3-Z_± FACSIMILE: ?/6'. _Oil 22V <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only- must be confirmed) <br />0 CHECK BOX TO EXPEDITE REQUE T,25 F (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />- <br />1 Electronic Information: Li List 'LI Map — Description: <br />, <br />FILE ADDRESS EHD USE ONLY <br />D Unit 1 Street # Street Name City <br />1. 3 ? 5 / N'; 1/0 I_SdAil 14%ç Y 511""ee-f7jt <br />-'7cicie7:0>ti 2:)File5 <br />S'7Xe7&A-/ <br />1 0° <br />0 VI k <br />)05 2 . <br />0 Unit 2 2' 97-5---- At. WI L 5 0 A/ it//gY <br /> 1/ Oa / /V; I ,V7Z.SOW )1W L? <br /> zkoO 7 Az m L coil <br /> 4/1 OS-- At, It/ IL SW M:52' 5/ .glecK 7,-m/ <br />//&& n Unit 4 c- iVi Vit__Ceil ,t,VI.Pf/5-'7"cK -7,---iiV <br /> <br />0 Unit 5 <br /> <br />ii Unit 6 <br />Specific Date Range of Information Requested; From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />ILI UNDERGROUND TANK (UST) CLEANUP SITE (LOP) . THER CLEANUP SITE (NON-LOP) <br />0 HOUSING ABATEMENT D FOOD FACILITY <br />LI SOLID WASTE FACILITYIVEHICLE <br />0 WASTE TIRE <br />NDERGROUND TANK (MONITORING/REMOVAL) 0 DOG KENNEL D DAIRY <br />HAZARDOUS WASTE GENERATOR D CHICKEN RANCH LI WASTEWATER TREATMENT PLANT <br />..TIERED PERMITTED FACILITY D MOTEL/HOTEL LI PUMPER TRUCK/YARD/CHEMICAL TOILETS D TATTOO/BODY PIERCING LI POOL/SPA LI LAND USE APPLICATION SITES D MEDICAL WASTE FACILITY El COMPLAINT RECORDS D OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00Pm (EXCLUDING HOLIDAYS) <br />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 />The p-ID will notify the applicant if any END files exist. An appointment for review will be confirmed approximately ten (10) <br />clays 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 />A file that is actively being worked on by END staff may not be immediately available for review. A new application may be <br />submitted when the file is available. <br />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 $125 deposit prior to review. <br />EHD USE ONLY <br />EHD 48-06 <br />811111 <br />SIGNATURE OF APPLICANT DATE