Laserfiche WebLink
JHN-5O_ZUUIi 05 : 12 Pm P. 01 <br /> -- ,DATE RECEIVED;-; EHO LOG NUMBER <br /> SAN JOAQUIN COUN'T'Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> L' 600 East Mair) Street, Stockton-CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web: wwwsjgo314? <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: I BUSINESSIAOENCY: Pcft y <br /> ADDRESS:_ 2909 4l[6�ff <br /> PHONE[1):. - ��S"O 77`� _PHONE(Y):___V�j�/���J? 7 _FACSIMILE;_- se-%7•e��j'9I1cr <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 bualneas da om date of application sublDlttal-•tontatim only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUES It,F E( ASH OR CHECK ONLY)•REQUEST PROCESSED IN 3 B SINES DAYS <br /> SIGNATURE OF APPLICANT DATE '30 O$ <br /> Electronic Informatlonl ❑ Llat U Map–Dsscrlptlon: <br /> ADDRESS EHD USE ONLY <br /> _ _... <br /> .------ <br /> _ Street Nama <br /> City El Unit 1 <br /> nit 4 <br /> 7. <br /> 8. Unit S <br /> _...._.. _.... _......_ .. <br /> — _ <br /> 10, unit <br /> Specific Data Range of Information Requested:From ..___... _ to <br /> y,/ ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �y UNOE"OUND TANK NOT)CLEANUP SITE(LOP) O HOUSING ABATEMENT ❑ �. V—• 'I <br /> SOLID WASTE FACIuriNEHICLE <br /> 0 OTHER CLEANUP SITE(NON-LAP) ❑FOOP FACILITY E3 WASTE TIRE <br /> y/a�0 <br /> �UNOERORWNDTANK(MONITORINO1REMpyAL)✓ ❑fX)G KENNEL C3 DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY O MOTELIHOTEL ❑PUMPER TRUCKNARDICHEM TOILETS <br /> M'FATTOOIBOOY PIERCING OPOOLISPA ❑LAND USE APPLICATION SITES <br /> t7 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFYL <br /> WELL ANO SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW. MONDAY-FRIDAY B:DO AM-S:DDPM - EXCILDINO HOLIDAYS. <br /> 1. List up m tan NO <br /> in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one ills type MUST be selected. Foto 1208)484-0158 or mall I21bo addresa Indio above Address <br /> ranges will not be accepted–for additional assistance with fila 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 continued approximately tan(10) <br /> days after receipt of application. The files will be hold 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 now application may be <br /> submitted when the file Is available. <br /> 4. Any file hot returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant, <br /> Future fila reviews by the same applicant may require a$88.00 deposit prior to review. <br /> EHD UBE ONLY <br /> �s/o�: �� �! z{usr� al,il b mom;. k-� N az whsle F% avA;lab/� u�7n re9�,,1a <br />