Laserfiche WebLink
EHD LOG NUMBER <br /> DATE RREEC(EIIVV(EDD M SAN JOAQUIN COUNTY <br /> W 1—I--1�?L=� V ED ENVIRONMENTAL HEALTH DEPARTM 'NI' <br /> AUG 1 1 2009 00 East Main St. Stockton, CA 95202-2708 qls�ls Telephone: (2209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/e)ENVIRONMEN r HEALTH <br /> PEWIT/SERVICC7ES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 0 i P a �3 BUSINES <br /> S/AGENCY: <br /> ADDRESS: 2.59 N ITY/STATE/ZIP h I I�O r"� C� 9 S 36 <br /> PHONE(1): 20 4 S9 9 '- 'L 10 g PHONE(2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$115.00 FEE(cg.,ki OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Jb� G Iuct A� <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name /� City El Unit 1 <br /> 1. M 4AS6A)'S DRI 5TODKTV' j Av6 ONS ek <br /> 2. 4/JD SFcoN� �`rQET it1•WE5 7 ❑ Unit2 <br /> 3. 23 S. S7�LIC tOrJ , I Unit <br /> 4. <br /> 5. Unit 4 (I <br /> 6. <br /> 7. ❑ Unit 5 <br /> 8. - <br /> 9. ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DTSIINDERGROUND TANK(UST)CLEANUP SITE(LOP) 11 HOUSING ABATEMENT 0 SOLID WASTE FACILITYNEHICLE / �• <br /> OTHER CLEANUP SITE(NON-LOP) �/ 13 FOOD FACILITY 0 WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL){^ ❑ DOG KENNEL 0DAIRY <br /> ClHAZARDOUS WASTE GENERATORQ` ❑ CHICKEN RANCH 13WASTEWATER TREATMENT PLANT13 ritT/ 6 <br /> TIERED PERMITTED FACILITY Dt, ❑ MOTEL/HOTEL 1:1 PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOO/BODY PIERCING ❑ POOL/SPA 0 LAND USE APPLICATION 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 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—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$115.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***Ifyou need further assistance please contact Diane Martinez @ (209)468-3425 'directly. Thank You*** <br /> 2 <br /> erotrz00s <br /> EHO 48.06 <br />