Laserfiche WebLink
lrf��FRp�Aas g tai, 1 � <v+cn)llgF 10 2010 12:66/ST. 12:66/No.7600000321 P l <br /> IiII1I O^L�JLM+(•IIIIIIIECYf�III1II������EyJ/�/// �m¢n �.F <br /> '+ .../ EHD LOG NUMBER <br /> SAN .JOAQUIN COUNTY <br /> MAR U ZD)� ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRUN&I01T HEALTH Tb 600 East Main St. Stockton, CA 95202-3029 <br /> PERMIT/SE...... a one: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/e dd <br /> PUBLIC RECORDS RELEASE APPLICATI�O-Np rQ <br /> APPLICANT: 2U L vc Q BU I NESSIAGENCY: Gn �nV�ronne4 <br /> ADDRESS: IS33 $ s c ATEOP: 4Akju .A ,CA— <br /> PHONE(1):310-IL41-7-1138,57-4-36 D+HONE(2): -PHONE(1):S1D'Iy-7'1B8,57-4-36D+HONE(2): CSIMILE:SIO 'SE(s s3 <br /> TENTATIVE'APPOINTMENT DATE: ,3- -I T e: <br /> (Please allow 10 business days from date of application submittal-'Ten confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$115/F AS OR CHECK ONLY)-REQUEST PR SSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT�G?` DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City0 Unit <br /> 1. 2r�On [7Pr 11 G/T Z ��j N� l ti� <br /> 2' " O MmA- S,Q re k S n o Unit 2 /V <br /> 3. N F S <br /> 4. 0 h' 7�0 e- <br /> L�� <br /> s. <br /> UnN 4 <br /> 7. -;- At Allb <br /> 8' 'vmom Unit 5 <br /> 10. ' <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From to �r <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLD WASTE FACILRYNEHICLE <br /> ER CLEANUP SITE(NON-LOP) ❑FOOD FACt1TY ❑WASTE TIRE L� <br /> UNDERGROUND TANK(MONITORINGIREMOVAL)G(� El DOG KENNEL ❑DAIRY �[ <br /> HAZARDOUS WASTE GENERATOR [ICHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERwTTEO FACILITY ❑MOTELIHOTE ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATK)N SITES <br /> ❑ MEDICAL WASTE FACILITY ❑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 typo(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464.0138 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 H any EHD files exist. An appointment for review will be confirmed approximately ton(10) <br /> days after receipt of application. The files will behold 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 reorganised by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$11S deposit prior to review. <br /> S. H you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> a 3 <br /> e r S S <br /> END 46-H Mnea <br />