Laserfiche WebLink
03/22/2005 15:45 1707877-2276 ANTON r PAGE 01/0 <br />DATE RECEIVED SAN JOAQUIN COUNTY � 6HD LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.42iRAR; pWt :i , <br />PUBLIC RECORDS RELEASE APPLICATIONA JO, tIUIN COUNTY <br />APPLICANT: /� &n—o BUSINESS/AGENCY: A�iE I <br />ADDRESS: 0. <br />1�0?C370 , CLIC. 11A 7s" 3 -037 <br />PHONE (1): 1`Y` X7 /"? / 07 PHONE (2):LZo-Z)2-l7 S2:7? FACSIMILE: (70-7) <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date o application submittal- "Tentative only - must be confirmed) <br />13 CHECK BOX TO EXPEDITE REQUEST�EERCHECK ONLY) - REQUEST PROCESSED IN 3 USINE S DAYS <br />SIGNATURE OF APPLICANT- DATE2- Oma._ <br />UNIT DISTF4IBUT{ON <br />O Unk 1 0 Unit 2 P6 <br />191-t 8 �" _ dt'ei';;.CI Unit 6 <br />Unit 6 O Other (electronEc/list9/maps) <br />Street IF <br />FILE ADDRESS <br />Street Name <br />city <br />EHD USE.ONLY <br />1 • <br />N�. <br />_ <br />2. I:ST h.J� T'oG4CT"2� <br />3. <br />02 L. <br />4. <br />6.9. <br />0. 1 <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT I3 SOLID WASTE FACILITYIVE9HICLE <br />OTHER CLEANUP SITE (NOWLOP) 0 FOOD FACILITY 0 WASTE: TIRE <br />X,UNOEROROUND TANK (MONITORINGIREMOVAL) C3 DOG KENNEL, 11 DAIRY <br />XHAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />0 TIERED PERMITTED FACILITY 0 MOTELIHOTEL E3 PUMPeR TRUCKIYARD/CHEM TOILETS <br />0 TATTo0/BODY PIERCING 0 POOL/SPA 0 LAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY C3 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAIL.ARLE FOR REMEW - MONDAY -FRIDAY 8:00 AM-6,00PM - EXCLUDING HOLIDAY$. <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) 4640138 or mail to the address <br />Indicated above. Address ranges will not be accepted — for additional 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 rzHD staff at the expense of the <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />." qq-UA-Uy4 <br />1114106 <br />