Laserfiche WebLink
02/17/2011 19:03 12098389883 BARBARA PAGE 02 <br /> R�. Iv -HD LOG NUMBER <br /> SAN .1OAQUIN COUNTY <br /> -8 22 2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> ENVIRONMENTALEICES� WoNe. (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 6XL' 601;z \/ �' sr��� BUSINESSIAGENCY: 6/"ZOuND LF"& Alv4r(,YSIS <br /> � q20 <br /> ADDRESS: rcAc " <br /> PHONE(1): 704 $ "t PHONE( FACSIMILE:Sig�q gg� <br /> TEN TATIVE"APP OINTMENT DATE (/ Time: (o: (>d <br /> (Please allow 10 business days from date of ap Ilcatlon aubnilttal-*Tenta6va only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$122 FEE SH CHE ,JS.ONLY)-REQUEST PROCESSED IN 3 PUSIPftSS DAYS <br /> SIGNATURE OF APPLICANT DATE 2z T <br /> Electronic Information: .❑ List❑ Map—Description: <br /> FILE ADDRESS ENDUSE ONLY <br /> Stroet# Street Name City Unit 1 <br /> 2 [J unit2 <br /> 3. ... <br /> 4 unit3 0� <br /> 5. <br /> 5. Unit4 <br /> 7. <br /> S D Unit 5 <br /> 9. <br /> 10. Unit 6 <br /> Specific Date Range of Information Requested: Fromto <br /> ALTH n <br /> ENVIRONMENTAL HEDEPARTMENT FILES /� �j <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYIVEHICLE J� , <br /> ryryry����]rrr''1THER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> 7�yNDERGROUND TANK(MONITORINOIREMOVAL0\ ❑DOG KENNEL El DAIRY <br /> /E]HAZARDOUS WASTE GENERATOR F-1CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT % �J <br /> F]TIERED PERMITTED FACILITY F-1MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALToILETqS/u� <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 9:00 AM-5:0OPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the apace above. Select the type(s)of files from the list above by checking the appropriate <br /> box(e9). At least one file type MUST be selected. Fax to(209)484-0138 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 /> Future file reviews by the same applicant may require a$122 deposit prior to review, <br /> EHO IIaE ONLY <br /> VON <br /> suo 48-00 <br />