Laserfiche WebLink
09/25/2007 08.51 FAX 5307585672 FEDEX KINKO'S DAUIS Z002/003 <br /> DEHD LOG NUMBER <br /> ATE RECEIVED <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.o hd <br /> (113 <br /> PUBLIC RECORDS RELEASE APPLICATION L <br /> APPLICANT: ��r11 - �" e 0 1 BUSINESS/AGENCY: con Su �T�2,'_f <br /> ADDRESS: H U e— C K 9 S6/6--ei�5-3 l� <br /> PHONE /5 ,0 75 8—gam�3 -PHONE(2): —FACSIMILE:FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-`Tentative only-must be confi <br /> CHECK BOX TO EXPEDITE R QUEST-$98.00 FEE(CAS HECK ONLY)-REQUEST PROCESSED IN 3 S A <br /> NATURE OF APPLICANT DATE Z <br /> Electronic information: ❑ List[I Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street A Street Name City ❑ Unit 1 <br /> F2. <br /> 170 fj <br /> nl0 tgnit 2 <br /> 3.L, N Tb o a fbn Fo 9�B6 Lad i ldA <br /> ❑ Unit 3 <br /> 4.I W Sa.r en 3 -- tom A45 gS1 pcL <br /> f�os - - <br /> 5 -5,4 ❑ Unit 4 <br /> V0 6 <br /> 184/ <br /> c ' 1-0� i /U <br /> Y' 1 Ramz 80 � ❑ Units <br /> 51 v 1 _ ���,:.� t� 1 � / q ��G�z vP 9�-a9 y4 oil;92.22;9/-ids�a!,sv. <br /> 9 12-11 LoI�1G��cSC YGttiw� KIJ_ { 1„a 'e45 ❑ Unit <br /> 109 <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 13 SOLID WASTE FACT <br /> OTHER CLEANUP SITE(NON-LOP) 173 FOOD FACILITY 0 WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORINGIREMOVAL) <br /> K EL O DAIRY <br /> 13 HAZARDOUS WASTE GENERATOR HCH r]WASTEWATER TREA ENT LANT <br /> CI TIERED PERMITTED FACILITY EL 0 PUMPER TRUCK/YARDICHEM TOILETS <br /> •TATTOOIBODY PIERCING SPA �t.AND USE APPLICATION SITES <br /> •MEDICAL WASTE FACILITY HER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMITV0.VAA!A41LABLE FOR REVIEW-MONDAY-FRIDAY 8:00 AM-S:tIOPM -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 /> _--- tfays hfterrecetpf of application.-The files Will be-held for a maximum of five business days for review.-Appointments <br /> - <br /> should - <br /> he scheduled AceDrdingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new app Ica on may e-— <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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 46-06 WEB&182007 <br />