Laserfiche WebLink
09/19/2010 08:34 FAX 9 168529 1 2LA Geocon Consultants 2001/001 <br />DATER EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />CC'nR ��a ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main St_ Stockton, CA 95202-3029 <br />(209) 468-3420 Fax. (209) 464-0138 Web: wvvw.sjgov.org/5h5 <br />PUBLIC RECORDS RELEASE APPLICATION <br />AMLICANT: (Zt? nj BUSINESS/AGENCY._ <br />ADDRESS: _. �j(Cp� (�btJ,� 11�a,L r j)(L CITY/STATE/ZIP: , 0 CptaQtj 9 9L4Z <br />PHONE (1):(9t�� $57- -9 i (g PHONE(2):�d,'z� loZa-�(o�-S FACSIMILE:Cgc4>� <br />TENTATIVE* APPOINTMENT DATE: - 2-(- (1b Time: I <br />(Please allow 10 business days from date of application submittal -Tentative only - must be confirmed) <br />CHECK BOX TO EXPEDITE REQUEST - $122 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIG ATURE OF APPLICANT DATE 1 t — (c'-� <br />Electronic Information: ❑ List ❑ Map T Descr(ptlon: <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACT <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD rACILI Y WASTE TIRE % <br />UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ DOG KENNEL DAIRY <br />HAZARDOUS WASTE GENERATOR <br />❑ CHICKEN RANCH WASTEWATER TREATMENT PLANT <br />TIERED PERMITTED FACILITY ❑ MOTELIHOTEL PUMPER TRUCKNARDICHEMICAL TOILETS <br />TATTooftay PIERCING ❑ POOLISPA LAND USE APPLICATION SITES <br />MEDICAL WASTE FACILITY ❑ OTHER (PLEASIZ SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. LW_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 L209) 484-0180 or mall 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 EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br />day@ 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 EMD staff may not be Immediately available for review. A now application may be <br />submitted when the file is available. <br />4. Any file not returned In the some condition as released will be reorganized by EMD staff at th a f the applicant. <br />Future file reviews by the same applicant may require a $122 deposit prior to review, r:. a „y <br />