Laserfiche WebLink
Jul -16-07 03 : 23P Krazan and Assoc 559 348 2190 <br /> DATE RECEWED SAN JOAQUIN COUNTY • "'�`�� •-^_P 01 <br /> 1qT1%1 L ENVIRONMENTAL HEALTH DEPARTMENT <br /> Sh 304 East Weber Avcnue, 3r4 Floor, Stockton,CA 95202-2708 <br /> � [ Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT' � BUSINES�S>IDAG .w <br /> �ENCY: nq,43,es � <br /> 5 "J/ Qct <br /> ADDRESS: IZ<j M) f /cA�n p—{'/i� CITY '�.r�oLL✓ STATE C•' �- <br /> PRONE(1):�5�ri�� <br /> 9/44PHONE(2): FACSIMILE�h -y jJ � �� ��4�/; <br /> _ - T ENTATIVE4 APPOINTMENT DATE: Time: <br /> -- (Phase allow 10 business days from daft of application Submittal-*Tentative Only-must be;o flrmod) <br /> ❑ CHECK BOX TO GXPEDRE REQU •$93.00 FEE(CASH OR CHECK ONLY)•REGUESS SSEO IN 3 BUSIN S OAY <br /> SIGNATURE OF APP'iCANT --� DATE <br /> 777,_ <br /> ❑ List ❑ Map-DescripD <br /> Information <br /> FILE ADDRESS EHD USE ONLY <br /> shat a Street Name City <br /> 2 x r �� _ ❑ Unit 1 <br /> 3. ❑ Unit 2 <br /> � a. <br /> Unit 3 <br /> Unit 4 <br /> 7.e ❑ Unit 5 <br /> 9. <br /> 10. ❑ Unit 6 <br /> Speck Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP sm;(LOP) ❑HOLDING ABATEMENT ❑ SOLID WASTE FACIUTY/VFHICLE <br /> '''0 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY (7 WASTE TIRE <br /> UNDERGROUND TANK(MONrroRINOIREMOVAL) O DOD KENNEL O DAIRY <br /> 14AZAROMS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATFR TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELMOTEL ❑PUMPER TRVCKIYAtOrHZ"H:AL TOILETS <br /> a TATTOOIBODY PIERCING ❑PDOVSPA ❑ LAND Use APPLICATION SITES <br /> D MEDICAL WASTE FACILITY K,19.Oni"(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AV aLE POR REVIEW-MONDAY-FRIOAY 8:00 AM•6:11DOPM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2 9)464-0138 or rrell to the address <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses, contact <br /> the EHD.Applications received after 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 <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immedlately available for review. A new <br /> application may be submitted when the fete 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 <br /> applicant. Future file reviews by the same applicant may require a$93,00 deposit prior to review. <br /> END 4a4N <br /> rgal/ESGr <br />