Laserfiche WebLink
EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />'JUL. 5 2D13 ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />epne:(209) 468=3420 -Fax (209) 464-Gl38-Web: www.sjgov.orgrffd / <br />PUBLIC RECORDS RELEASE APPLICATION rr <br />APPLICANT: �.er 77 L"11Z <br />r BUSINESSIAGENCY: <br />ADDRESS: L S 'r s' �P r,C A � CITY/STATE/ZIP: Sc1 Eq \�2t� �- Tq!2o <br />PHONE (1) f�x�-( 6 G - 5Z PHONE (2): FACSIMILE: <br />TE TATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE RE� 125 FEE (CA C ECK %%Y) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT 1dLt? C cX DATE 05 ;rn 13 <br />Electronic Information: ❑ List ❑ Map - Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />y ❑ Unit 1 <br />Street # <br />Street Name <br />City <br />1. <br />icx� <br />�tx i g e wtat� 2 <br />L <br />m I No cols <br />m W - y Z <br />2. <br />So. eeX wta� S2 <br />' <br />Lod <br />3. <br />1f Unit 3 <br />4, <br />5. <br />Unit 4 <br />❑ Unit 5 <br />L7_ <br />Unit 6 <br />%5 <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />✓� DERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY E SOLID WASTE FACILIrTYIVEryV ICLE <br />YO HER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT [j WASTE TIRE JFje5 ArULA I13- <br />JuNOERGROUNDTANK (MONITORINGIREMOVALVI ❑FOOD FACILITY El DAIRY Hj <br />POVEGROUND TANK 01 ❑ CHICKEN RANCH/ DOG KENNEL �ASTEWATERTREATMENT PLANT <br />AZARDOUS WASTEIHAZARDOUS MATERIALS V(, ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />1 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 - 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 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 />.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 />thp same 'cant mav require a $125 deposit prior to review. --BOXED AREA- EHD USE ONLY- <br />NLY— <br />/- <br />EHD <br />EHD 48.06 <br />----------- <br />EHD <br />EHD 48.06 <br />