Laserfiche WebLink
04-24-20009 11:13am From- _ T-963 P.002/002 F-027 <br /> W EEE V ED ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 ////eV <br /> Af.R 2 4 2009 Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjg42 n <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION////// <br /> -1 -I Gr <br /> APPLICANT; AKOr1 1iAKt[4FANDI�ry BUSINE$$IAGENCY: NVI1?0N <br /> ADDRESS: W61 tS1f&LMd1/ND ST, 57E 700 cityistatemp 'r MIr RE�VILLI CA 1514008 <br /> N JAI <br /> PHONE(1): DI K 20 X / <br /> 03 <br /> 5PHONE FACSIMILE: `10��3577 <br /> TENTATIVE'APPOINTMENT DATE: MhV (O �IFPDSSIt�jU=� Time: <br /> (Please allow 10 business days from date o�f applleffiion submhtal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDrrE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT SVAA&AAd,twC�a a o_ DATE 412-412.009 <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> A� Street rt Street Name city <br /> (vim 1• 12•!01 E 8 locv_.>✓Fp taz 5 ❑ n� <br /> v z. <br /> 3. <br /> 4. Unit3 <br /> 5. <br /> Unit A <br /> s. <br /> 7. <br /> ❑ Unit s <br /> 8. <br /> E <br /> Unit <br /> Specific Date Range of Information Requested:From lift U1 ax. iXF, to �12VGSC4A-1 - <br /> ENVIRONMENTAL HEALTH DEPARTMENT�FuIILES <br /> IUNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT X.SOLID wASTE FAci.RYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTETIRE t1 / <br /> UNDERGROUND TANK(MONITORINGIREMOVAI4D` O DDG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR Oi. O CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACxI1Y D` O A10TELIHOTEL PUMPER TRUCK/YARDICNEM TOILETS I�I�� <br /> O TATTOOIBoDY PIERCING O POOLISPA �� �� D USE APPLICAT10N SITES I <br /> �MFDICAL WASTE FACILffY� DINER(PLEASE SPECIFY"W L SV STEMS <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM•510OPM - EXCLUPING 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 END. Applications received after <br /> 3:00 pm will be processed the next business day- <br /> 2. The END will'notify the applicant IF any END 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 END 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 END Staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> END USE ONLY <br /> f(a <br /> D I at ZS PS <br /> EHD 48-06 8104108 PUBLIC RECORDS RELEASE APP FORM <br />