Laserfiche WebLink
11/0812016 4 : 30 : 33 PM -0500 FAXCOM ANYWHERE PAGE 3 OF 3 <br /> DACL,.. E EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY 8 <br /> F%LwCENVIRONMENTAL HEALTH DEPARTMENT �5 01 Lo <br /> NOV 6 96M 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 4640138 Web: www.sjgov.org/ehd <br /> EWR )NMENTAL 1-T. <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Amanda Benbow BUSINESS/AGENCY: Py Environmental <br /> ADDRESS: 3400 Douglas Blvd Suite 200 CITYfSTATE/ZIP: Roseville, CA 95661 <br /> PHONE (1): (916) 472-2870 PHONE (2): FACSIMILE: (877) 884-6775 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arran a an appointment date and time to review the requested records. <br /> CHECK BOX TO EXPEDITE UEST $ '3O FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 11/812016 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY t <br /> Street# Street Name City ❑ Unit 1 l�l <br /> 1. 1789 Vilest Charter Way Stockton f <br /> 1817 South Fresno Ave Stockton 0 C19 Q'Unit 2 <br /> 3 1a <br /> 4. <br /> dunit s <br /> 043 T <br /> 6. <br /> tJntr <br /> 7. <br /> 8. <br /> ❑ Unit 5 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITY/VEHICLE <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITOR]NG!REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOoIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑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 appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 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. The 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 EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. ***BOXED AREA- EHD USE ONLY*** <br /> 2 / ,r" 6 <br /> © Iv <br /> Ce003�iS� . <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: i� <br /> Received Time Nov. 8. 2016 1 : 21PM Nice, 0315 o$!o'r'4 <br />