Laserfiche WebLink
6ATEQcQ ED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> APR O 5 Ni! ENVIRONMENTAL HEALTH DEPARTMENT /^ 5[3 77 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 (TVl+l <br /> ENVIRONN�lF(ALFfPwTH Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PEMIT/SERVIi:ES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: atfL%� hOff-.Syl?Lt BUSINESS/AGENCY: pcy� / U5l <br /> ADDRESS: CITYISTATE/ZIP: SCA At 50i <br /> PHONE (1): (fl'� "LyU` <•7"S7O � PHONE(2): FAX OR E-MAIL: 'j(hotf.5 d f+Y l'lTl al.J)`�t <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to reviewthe requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT P.-✓&yxCJ�•� ;.{d � DATE +5-'71. List up to ten addresses in the space be ow. Select the type(s)of files from the list below 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 $139 deposit prior to review. 4113 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:001"M(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> UNDERGROUNU TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) ❑CONSUMER <br /> 6 ��3H� Mwkek 51. `ikotk+ <br /> OTHER CLEANUP$ITE(NON-LOP) <br /> e HAZARDOUS WASTE ❑DAIRY <br /> ❑TIERED PERMOTED FACILITY 2 j(IJJ,y �urt L�. `k�i � IQ.t�/tjL,)//lftpun <br /> fd BOVEGROUND TANK t t J J J ►,/ft�Y)1Ar t <br /> RUST (MONITORING/REMOVAL) I PWS <br /> �HAIARDOUS MATERIALS ] Ir/vJ Mwko-t S+. Sf :�-oto �YV61r-2fN1 /&D <br /> Vills"ILURELEASE RESPONSE ATER QUA-11Y' <br /> ❑SOLID WASTE FACILITY/VEHIC�" 4 �� / `�K 1 utn ♦ i✓•� <br /> ❑FOCI FACILITY y� ` L/� N'r t/ <br /> POOL/SPA f-� /✓� ��V({��'/�- I�1{' ITE M/[I�T��G�ATI'O11N ��/�,/y��y/��/�t� <br /> DAIRY S'40movt - • N + -`• • V�' <br /> LAND USE APPLICATION SITES ^ 13 HOUSING <br /> ❑SEPTIC PUMPER TRUCK/ <br /> YARD/CHEMICAL TOILETS I� 7� ' `GICL/t �rk ��L•'���1 <br /> WASTEWATER TREATMENT PLANT CUPA <br /> ❑HOUSING ABATEMENT ] �tL 1{9 ,/L /^/ / /I <br /> (]MOTEL/HOYL.T�EL ���� M�,L,,, "�- "" "�r�/� /li (� <br /> �CHICKEN,WNCH/DOG KENNEL /� fRICUPA-UST <br /> MEDICAL WASTE FACILITY S ,��� /- t,_\ <br /> ❑TATTOO/BODY PIERCING ❑SOLID WASTE <br /> ❑WASTE TIRE G IM'' � <br /> �MPLAINT S �!� 1 Wtl.n / `V '�V� ,A`•[T�r/- <br /> ❑OTHER(PLEASE SPECIFY): ❑ACCOUNTING <br /> 10 <br /> OXED AREA EHD USE ONLY"' <br /> 22 <br /> 3 0 <br /> ❑ Records provided by Staff-PPR Complete. Starr Name: <br /> EHD 48-06 <br />