Laserfiche WebLink
SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JUL 0 9 2014 ENVIRONMENTAL HEALTH DEPARTMENT �~ ^ ,'01 <br /> TTee 1868 East Hazelton Avenue, Stockton, CA 95205-6232 )1f <br /> ENVIRONMENTALHEALRlephone: (209)468-3420 Fax: (209)464-0138 Web: WWW.sjgov.org/ehd I . <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: JO"J j Q . BUSINESS/AGENCY: S\'15XA \I 1hTA SIWt , <br /> ADDRESS: k-(%O PC.Pt% L1IC- C%7"( �j . S�\lF kOO CITY/STATE/ZIP: Ct51 ( S%$O <br /> PHONE (1): Rib -$SO—t 515 PHONE (2): FACSIMILE: "16 - S150 451(o <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST FE ASH O(2 CH CK ONLY)-REQUEST PROCESSED IN 3 B SIN SS DAYS <br /> SIGNATURE OF APPLICAN DATE 7 4.. k4- <br /> Electronic Information: ❑ List ap—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> oc <br /> fa�R\.V� PAVE. 4LlPOl�l a=Fcr ��q riASP <br /> 2. GOUnIt2 f7/ <br /> -7 <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> B. <br /> _ ._ _ _ ❑Unit 5 <br /> 9.' <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From \�a.�l to <br /> ,�-,,� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> LVf UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITY/VEHICLE ��\I <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ®'UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY vkj ' <br /> ❑ABOVEGROUND TANK ❑CHICKEN UiCiir DOG KENNEL ❑WASTEVIATER TREATMENT PLANT V' <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA - ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAINT/RESPONSE 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.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. 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 /> 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$125 deposit prior to review. * BOXED AREA-EHD USE ONLY" <br /> V <br /> It <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br /> 4128114 <br />