Laserfiche WebLink
DATE RECEIVED SAN .IOAQUIN COUNTY((�� EMD LOG NUMBER <br /> RIE`✓EI M�/ _ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> MAY 21 2Qq Telephone: (208) 468-3420 Fax: (209) 464-0136 Web; www.sjgov.org/ehd <br /> � <br /> PUBLIC RECO RS RELEASE APPLI <br /> USE,nlSCATION <br /> APPLICANT { (_ SIAGENCY: 6wilge <br /> ADDRESS: 3t7O M, Wij(hg 13jVA S-Al—C M <br /> CITYISTATEiZIP: oh <br /> PHONE (1): 1-001 6 9 q�60q PHONE (2): Zv9 '321 '��6 rFACSIMILE: 08jb? 2 <br /> TENTATIVE"APPOINTMENT DATE: -- 1% Time: F 3u <br /> (Please allow 10 business days from date of application submlttal-"Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REq125 FEE(C H OR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATEI1- <br /> Electronic Information: ❑ List❑ Map-Desci'I on: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City 42 D unit 1 <br /> 1• QI VC _Rloor% Zi .W <br /> 2. Ebrilt 2 <br /> 3. <br /> 4. aunit3 / <br /> 6. u]R4 <br /> 7. <br /> 8• U <br /> 9, <br /> 10. O Unit <br /> Specific Date Range of Information Requested: From t0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ������{{{ <br /> 511 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E]HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE 1 t1 <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOo FACILITY WASTE TIRE;511 2 <br /> UNDERGROUND TANK(MONITGRINGIREMOvAL) ❑DOG KENNEL DAIRY LN)Ir3 ' <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH ,, 2 <br /> TIERED PERMITTED FACILITY ❑WASTEWATER TREATMENT PLANT �- <br /> ❑MOTEIJHO7EL (PUMPER TRUCK/YARDICWEMICALTgILETS <br /> ❑TATTOOIBODY PIERCING ❑POULISPA <br /> ❑ MEDICAL WASTE FACILITY ❑LAND USE APPLICATION SITES <br /> ❑COMPLAINT RECORDS ©OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S: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(2081 464-0138 or mail to th®address indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:UO 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 EHO staff may not be immediately available for review. A now 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 EMD staff at the expense of the applicant. i <br /> Future file reviews by the same applicant may require a$1 it prior to review. I <br /> I ' � ,. <br /> K' <br /> 1J <br /> \N <br /> EHD 4eae i e <br /> J <br /> 0ltHt <br /> TO 39Vd NOdIaO39N3 96Z166S60Z 61;2:�K ZTOZ/TZ/50 <br />