Laserfiche WebLink
NOV-27-2012 08:06 Martin & Associates 904 674 6316 P.O1/01 <br /> lRbObVED EHD LOG NUMBER <br /> SAN .IOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> NOV 27 2012 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> cv>sEtli6trr---• <br /> APPLICANT; Carol Carol Wheeler BUSINESS/AGENCY: Martin Environmental <br /> ADDRESS: 8823 San Jose Boulevard Suite 103 CITY/STATE21P:Jacksonville FL 32217 <br /> PHONE(1): 904-737-1034 PHONE (2): 904-437-2417 FACSIMILE: 904-674-6316 <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-•TentatlYe only-must be confirmed) <br /> []CHECK BOX TO EXPEDITE RE EST-$115 FEE(CASH OR HECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE1/ 4=I;2 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> 1'(I Street 0 Street Name City Unit 1 <br /> wv 1 1153 Vanderbilt Circle Manteca <br /> 2. <br /> IYI <br /> 3 ❑Unit 2 ���\rl' 4_ 5 <br /> 5 Unit 3 <br /> 6. <br /> T Unit 4 <br /> 8. <br /> El Unit 5 <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES - <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT _ <br /> ' ❑SOLID WASTE FACIrLI (VEHICLE <br /> 'r�TO1THER CLEANUP SITE(NON-LOP) [:1 FOOD FACILITY 3h LIM <br /> / 3. <br /> ,RZNDERGROUND TANK(MONrTORING/REMOVAL)� ❑DOG KENNEL El TIRE �J rv� <br /> -HAZARDOUS WASTE GENERATOR �L. ❑DAIRY /�(P NT <br /> ,.1 _ ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> -TIERED PERMITTED FACILITY� ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTODIBODY PIERCING ❑POOL/SPA ❑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 fife 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 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> i - 7 7 <br /> 115 s o6 , <br /> EHD 49-06 Bn7/09 <br /> Received Time Nov. 27. 2012 5: 19AM No. 1695 <br /> Total P.OS <br />