Laserfiche WebLink
Cg-jVE® EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> p�flV S 2016 ENVIRONMENTAL HEALTH DEPARTMENT 815100 <br /> 1868 East Hazelton Avenue,Stockton,CA 95205-6232ENVIRONMENTAL HEALTH Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> • PERMITISMACES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT. Er ' Z• BUSINESSIA:GENCY:LC3ffe t lelC' <br /> ADDRESS: D CITYISTATEIZIP:—Aelvw --�� _0 <br /> PHONE(1): JPHONE(2): FAX OR E-MAIL:-�.Gll lt"/U'CZ!"u rJC�'(.Qn T4 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EX TE REQUES -S F E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINF. S DAYS <br /> SIGNATURE OF APPLICA DATE ALU <br /> 1. List us)to ten addresse -In the space be elect the typ ( f files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be aWacted. F x to 20 0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. Ths,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 /> 4. Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT REC RDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: List on:ap—Descripti11M371 tL64111V <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLY <br /> FILES <br /> NOERGROUND TANK(UST) SUeet# Slreat Name City <br /> CLEANUP SITE <br /> • SITE(LOP) <br /> CLEANUP SITE(NoA.LOP) t{5 W w lo-M <br /> EM0AlSvy ❑CA=L <br /> 000SWA5TE N9NMER <br /> I2�1 <br /> CLARY <br /> 041ERED PERMITTED FACLLIIY 1 <br /> �(YmeaROUNo TANK , I-[L�F•(V i VE 1 r`✓' V 1/C tV( {� <br /> [ PWS <br /> iTH (MONITORING/REMOVAL) <br /> RGOAMATERMLS <br /> S /RELUESSE <br /> RESPONSE 1 f rlti i n" /t r.rj <br /> �L'-1T'w WATER GN4ITY <br /> dSOLIO WASTEFACILITY/VEHICLE r/)r�o � 0 <br /> ❑FOOD FACILITY w <br /> ❑POOL/SPA A ny/� ILh c7 ��µ�L]�//LJ/Ly,,���E����� mwnox <br /> ❑ AIRY .w-i'4/1 <br /> USE APPLICATION SITUCIHM&NO <br /> EPTIC PMNPER TPVCN/ �^ <br /> WARD/CHEMCAL TOILETS <br /> WASTEWATER TREATMENT PLANT CUPA <br /> ❑HOUSING ABATEMENT p <br /> ❑MOTEL/HOTEL <br /> ❑CHICKEN RANCH/Doo KENNEL CUPA-UST <br /> ❑MEDIAL WASTE FACIIRT a <br /> ❑TATTO0/800Y PIERCING 4 WanE <br /> ❑WASTE TIRE <br /> 9 <br /> ❑COMPLAINT <br /> ❑OTHER(PLEASE SPECIFY). ❑ALTAUHR,q <br /> 10 <br /> —BOXED AREA-EHO USE ONLY— <br /> . � V <br /> ❑Records provided by Staff-PPR Complete. Stan Nam'W <br /> EHO 41*11 / <br />