Laserfiche WebLink
07/24/2007 11:49 530BB7 j5 BLACKBURN • PAGE 01/01 <br /> �(.� R� ``, y� L� 'I EHD LOG NUMBER <br /> 1�ff D SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUL 2 4 2007 600E.Main.Street, Stockton,CA 95202-3029 2/1 <br /> E1JI RL°vELr> I rEkL7HTelepbone:(209)468-3420 Fax:(209)464-0138 Web:www.s <br /> PFRklliT/S[I:R JCF.S PUBLICRECORDSRELEASE APPLICATION <br /> APPLICANT: � Af �/-- BUSINESSIAGENCY• <br /> ADDRESS: �Is2I / /� y �j(( " C�_ <br /> PHONE(1): �fk- ea o. ' B. '.S TENTATIVE'APPOINTMENT DATE: sem rS®F� F Tlme: ply <br /> llow 10 business <br /> from <br /> SIAIJ <br /> entatin <br /> irm <br /> Ar'CHECK BOx TO aExPEDTE REOUES �$6 0 date D appall 0RECK IH LV)T REQUES DI ust coNf3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 0 E x �� <br /> Electronic Information: ❑ List❑Ma Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street f Street Name Fity tt,sr(61)��W G i) 0a ❑ Unn 1 <br /> 2. /�� 71! 0.... ❑ unit 2 <br /> 4. <br /> S. <br /> ! � & � unna <br /> 50 d ❑ unit S <br /> �l <br /> 8. <br /> . .. <br /> 10. Iftv <br /> El <br /> Specific Date Range of Information Requested:From _ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUNo TANK(UST)CLEANUP SRC(LOP) ❑HouSING ABATEMENT ❑SOLID WASTE FACIUTYIVEHICLE <br /> "iER CLEANUP SITE(NOWI-OP) ❑FOOD FACILITY 0WASTE TIRE <br /> 6ff 0RGROUND TANK(M110NITORINGIREMOVAL) 0 DOG KENNEL C3DAIRY <br /> Se HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 0TIERED PERMITTED FACILITY 11 MOTELIHOTEL ❑PUMPER TRucx/YARD/CHEM TOILETS <br /> O TATTOOIBODY PIEROINO O POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ©OTHER(PLEASE SPECIFY) <br /> WELL AND SCPTIC PERMIT RECORDS ARE AVAILABLC FOR REVIEW- MONDAY-FRIDAY 6:00 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 t0 0 464-0138 or ma I o the address Injilcated above. Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD flies 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 /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review, A new application may be <br /> 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 applicant. <br /> Future fife reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> lND 11.OB&tarypoa web <br />