Laserfiche WebLink
C r EH0 LOG NUMBER <br /> �' ; SAN JOAQUIN COUNTY <br /> �C <br /> �` 'I11 ENVIRONMENTAL HEALTFII DEPARTMENT <br /> n z600 East Main Street, Stockton, CA 95202-3029 <br /> .,I oil:< 0�8 Telephone: (209)468-3420 Fax; (209)464-0138 Web: www.sjgov-Org/ S�?`Z <br /> ENVii (1,N iE:P:I HLAil9i PUBLIC RECORDS RELEASE APPLICATION <br /> OCt1 ftiTlCCR t' .4 <br /> APPLICANT: q��A VC– Z H APA1,4 - _BUSINESSIAGENCY: Eg,g L_. �.c1M /IG/A1. aL i A <br /> ADDRESS: '�11292 _�L�4,I FY[- AVE �_ G-,-D C.;,J_�•LO G/�_ 795^ZOQ- .--'_ <br /> PHONE(1):_,2D7– 4I f PHONE(2): 2eJ5 649"'694-d–_____FACSIMILE: c rj_-4-b� -64-10 <br /> 4 <br /> TENTATIVE'APPOINTMENT DATE: /L3/09 Time:_ A9 '0'F'�_,_ <br /> (Please allow ten business days from date of application submittal-'TentaGvo only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$98. E (CASH OR CH REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE /00 <br /> Electronic Information: List❑Map-Description: 14U- ye?g-a i AA rvy i /AJSP,:G r/pA2: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City M Unit 1 <br /> 16F 13 Z-3 _ CHA2 2 iJ wS1" oz� . u) ) '.0(555o! <br /> 2.— D nit2 <br /> 3. <br /> 4. <br /> 5. <br /> Unit4 <br /> 7, <br /> `O 8. <br /> ❑Unit 5 <br /> Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 12 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ZI HOUSING ABATEMENT O SOLID WASTE FAGLITYNENICLE �!//- <br /> XOTHER CLEANUP SITE(NON-LOP) LJ FOOD FACILITY 0WASTE TIRE <br /> 0 UNDERGROUND TANK(MONITORINWREMOVAL) Cl DOG KENNEL M DAIRY <br /> HAZARDOUS WASTE GENERATOR 0, 13CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> M TIERED PERMITTED FACILITY 0 MOTELIHOTEL El PUMPER TRUCKIYARDICHEMTOILETS <br /> Ll TATTODBODY PIERCING 171POOLISPA O LAND USE APPocATKIN SITES <br /> Q MEDICAL WASTE FACILrrY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS AREAVAILABLE FOR REVIEw- MOPIDAY-FNIDAY 8:00 AM-S:ODPN; - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of Hiles from the list above by checking the appropriate <br /> box(as). At least one file type MUST be selected. Fax to(2091 484-N138 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> 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 <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 /> 3. A file that is actively being worked on by the EHD staff may not be Immediately available for review. A new application <br /> may be submitted when the file is available. <br /> 4. Any file not returned in the some 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 /> EMD{B-0B iY12810T PUBLIC RECORDS RELEASE APP rORM <br /> TOOQj OTC9 T9t 6OZ XVd CS:ZT 90/60/90 <br />