Laserfiche WebLink
V yr 6r 4v vv IVM L V 1 Ye Cne <br /> ,� � IQ991/001 <br /> DATE RECEIVED c <br /> SAN JOAQUIN COUNTY EHD LOO NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, 95202-3029 Sorg/ a �/ <br /> Telephone: (209)468-3420 Fax: (209)464-013838 Web:www.sjgov.org/ J <br /> PUBLIC RECORDS RELEASE APPLICATION 11 <br /> APPLICANT: Ka•h 1 P. L ac Ictn a rt BUSINESSIAGEEJNCY�: e? S r 4-s SO[I-Ct 1C S <br /> ADDRESS: p 3/. 1 ( Ca 'Dri've- V / D Ty-_'L_ �nP .7O <br /> PHONE(1): (((p -61 3­92 ci 3 PN'O'N'E(2); <br /> FACSIMILE: <br /> t b1 TENTATIVE'APPOINTMENT DATE:_ (0 13I U <br /> (Please allow ten buslnass days from nate Pf apph0a5on submittal-•Tentativconlylm must be con mod) <br /> 13 CHECK BOX TO EXPEDITE REQUEST-$9a, CASH OR CHE Y)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT IC DATE /0a <br /> Electronic Information: List❑Map-Description: C_PZ TZ a fif i u s MG{4 <br /> FILE ADDRESS EMD USE ONLY <br /> Street if Street Name city <br /> 15 K. rake f 1 ? u,5T(p) <br /> LV U <br /> Trac °]a3 ✓LD Cl Unit 2 <br /> 3. 3010 .I <br /> 4 L4 Sp 1 TGs ! Trac `1s V 62, i Htu oT)IDS 41 <br /> L' �cC — T� c r1 aSi(ut) : N2az,),ce ita \� <br /> s � W- Grgrtf L;,-v- lLoad <br /> e• 2 '>S3� _ro�Ec Z-4 T'rac <br /> U4 If( alta <br /> ��;4a lac 8• _ � Sr : CL1 CS.ibf � 6 Unit <br /> f3 `rs�so-- -.U/ • raKf ate, toad Trac "i .._ <br /> fo. <br /> nit 6 <br /> Specific Date Range of Information Requested: From to <br /> ��,.(( ENVIRONMENTAL HEALTH DEPARTMENT FILES ­71GUNDERGROUNDTANK(UST)CLEANUPSITE(LOP) O HOUSING ABATEMENT SOLID WASTE FACILITYIVEHICLE -6 c <br /> *OTHER CLEANUP SITE(NOWLOP) FOOD FACILITY ) WSOUD AS <br /> X UNDERGROUNDTANKG(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> IRE <br /> 17f HAZARDOUS WASTE GENERATOR 11 CHICKEN RANCH E3 WASTEWATER TREATMENT PLANT 1 v <br /> 171 TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKNARD/CHEM TOILET}., G <br /> U <br /> ElTATTOOBODY PIERCING ❑POOLISPA N SrtES Uv �/ <br /> MEDICAL WASTE FACILm' ❑OTHER(PLEASE SPECIFY) �LANDU9EAPPLICATIO1� la <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR l. MONDAY-FRIDAY8:DUAMS:oBPM-E%CLUOING HOLIDAYS. <br /> 1. List up to ton addresses In the space above. Select the type(s)of files Trom the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464.0136 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3.00 pm will <br /> be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD flies exist An appointment for review will be confirmed approximately ten <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 the EHD staff may not be immediately available for review. A new application <br /> may be 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 She expense of the applicant <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> E"'a.Eons.i' ! <br /> PUBLIC RECORDS RELEASE APP FORM <br />