Laserfiche WebLink
To: San Joaquin County EHD Page 2 of 2 2010-03-10 17:43:46 (GMT) 12094449999 From: Lee Helms <br />R"YED <br />EHD LOG NUMBER <br />SAN ..�OAQUICOUNTY <br />2010 ENVIRONMENTAL HEALTH DEPARTMENT <br />MAR 1 0 T,�t 600 East Gain St. Stockton, CA 95202-3029 <br />ENVIROMlENT HEALT "phone: (209) 468-3420 Fax: (209) 454-0138 Web: www.sjgov.orgf5d&9 <br />PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT:— c ig� DUSINESSIAGENCY: <br />ADDRESS. CITY/STATFJZIP . S �c o �•'� � t �`� �a *a <br />PHONE (1): 9�0 0 °,t V5 '05 V"4,i PHONE (2): ", o N g 19'6 013 4 i FACSIMILE "AO "% 'T I <br />TENTATIVE APPOINTMENT [SATE: 13_ t°� _ kr Time; 1 �- � a <br />(Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) - <br />❑ CHECK BOX TO EXPEDITE REQUES$115 FEE (CA H OR CHECK ONLY) - REQUEST PROCESSED iN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE'. S — cz —% -Z) . <br />12 <br />Electronic Information: Ij List [] Map — Description: <br />—Street # <br />FILE ADDRESS <br />Street Name <br />I City <br />EHD USE ONLY <br />❑ Unit 1 <br />❑ <br />uniea <br />2. <br />3. <br />4, <br />s. <br />--- <br />-- _ <br />Uriit <br />❑ Unit s Z -i_ <br />6 <br />6' <br />8. <br />8.1 <br />b.t <br />Specific Date Range of Information Requested: From + c' to m I Ca <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES ,r"" ---- /0 <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑HOUSING ABATEMENT [�'SOUD WASTE FA.CILITYli(EHICLE <br />THER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE <br />NDERGROUNa TANK (M-ONITOR.ING.1REMovAL) ❑ DRG KENNEL ❑ DAIRY <br />HAZARDOUS WASTE GENERATOl%A:_ ❑ CHICKEN RANCH El WASTEWATER TREATMENT PLANT <br />F1 TiEREDI'ERMITTED FACILITY ❑ MOTELIHOtEL ❑ PUMPER TwicKIYARDICnEmICALTOILE.TS <br />Q TATTOOIBODY PIERCING ❑ POOL/SPA ❑ LAN©! USE APPLICATION SITES <br />(MEDICAL WASTE FACILITY Q OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE. FOR REyIEw: MONDAY -FRIDAY 8:00 AM-5::00PM (EXCLUDING HOLIDAYS) <br />1. List un 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 fife type MUST be selected.. Fax to (2491464-0138 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 EHID files exist. An appointment for review will be confirmed approximately ten (14) <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 imtmedistely available for review. A. new application may be <br />submitted when the file is available. <br />4. Any filee net returned: in the same condition as released will be reorganized by EHD staff at the expense of the applicants <br />Future file reviews by the same applicant may require a $115 deposit prior to review. <br />5. If you need further assistance, please contact Diane Martinez, at (20% 468-3425. <br />