Laserfiche WebLink
MIE�EIVED <br />SAN JOAQUIN COUNTY <br />`J <br />NOV 1 4 2005 ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />ENVIRONMENT HEALTH Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />jj ERMIT/SERES <br />PLIC RECORDS RELEASE APPLICATION <br />fl <br />EHD LOG NUMBER <br />APPLICAVIC <br />NT: 2_ 1NNQr/ <br />BUSINESS/AGENCY: <br />TENTATIVE` APPOINTMENT DATE: _ <br />(Please allow 10 business days from <br />CHECK BOX TO EXPEDITER EST $9 0 F E (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 B INE S DAYS <br />SIGNATURE OF APPLICANT �Q�13m DATE I�`1�i�� <br />UNIT DISTRIBUTION In Unit ❑Unit ; Unit 3�; Unit4 ❑ Unit5 ❑ Unit ❑ Other(electonicl 11 tslmaps) <br />FILE ADDRESS" <br />EHD USE ONLY <br />Street Street Name City <br />1 O V <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />6. <br />9. <br />10. <br />In <br />Specific Date Range of Information Requested: From 4 1%'s to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITIETUSH <br />❑OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE <br />JK UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br />/❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br />❑ TATTOO/BODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <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 <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address <br />indicated above. Address ranges will not be accepted — for addltlonal assistance with file addresses, contact <br />the EHD. Applications received after 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 <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments 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 <br />application may be 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 <br />applicant. Future file reviews by the same a olicant may rpmoirp a aoa nn .,.;....,.._..:_.-. <br />FWn IN.n9.nna <br />11ma5 <br />