Laserfiche WebLink
JAN 22 1996 00:36 FR - TO 994640138 P.01/01 <br /> (� EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> " MILT `��L��)IENVIRONMENTAL HEALTH DEPARTMENT <br /> JUN 0 2 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: wwW.sjgov.o / & ` <br /> EWORClivft^, i HEALTH YYY//// <br /> PFu1�rrlsrq)llf rr' PUBLIC RECORDS RELEASE APPLICATION <br /> F-R-�AM1GtAI Ste' BUSINESSIAGENCY: <br /> APPLICANT:_ _— <br /> ADDRESS: q or ei� a o ( i� e (l A 4 a I <br /> PHONE(1): '4-M"2DSo IL051 . PHONE(]): 44Z5-4Bx, FACSIMILE; 1- .. ��Z <br /> TENTATIVE*APPOINTMENT DATE: Time' <br /> (Please allow ten business days from date of applleatlon aubMi tal--Tentat/ve only-muet be cDnermed) <br /> C3 CHECK BOX TO EXPEDITE REQUEST-$93.00 Ftucw OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT nM�c— <br /> m __T— DATE <br /> Electronic Information: Ej List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY _ <br /> street# <br /> Street name cityu��Ot� ;FhAJ �!):oCsS(6 ❑unit I <br /> 1. 2'52 Y�1 . W '9A �GY i <br /> ❑unit 2 <br /> 2. <br /> i <br /> 3. � <br /> 4. <br /> U 1 6. <br /> /A Unit 4 <br /> �I 8. <br /> 7. E3 Unit 5 <br /> 8. -- <br /> 9. <br /> ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑HOusINO ADATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> Fif-WHERG CLEANUP <br /> (UST)CLEANUP SITE(LOP) ❑FDOD FACILITY ❑WASTE TIRE <br /> OUNDER CLEANUP SITE(NON-LOP) ❑DDD KENNEL ❑DAIRY <br /> 7UNDERDOW W TANG GENERATOR <br /> RING/REMOVAL) 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIEREHAZARD ER WASTEHQEIL-ITT R OMOTEIJHOTEL ❑PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑TIERED PERMITTED PACILITY ❑ ND USE APPLICATION SITES <br /> In TATTOOIBODY PIERDIMO InPOOLISPA ,,// 1 <br /> OMEDICAL WASTE FACILITY �OTHER(PLEASESPECIFYf-g aL _s <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAULE FOR REVIEW . MONDAY-FRIDAY 5:00 AM5'DOPM . EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 12091464-0138 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 files exist An appointment for review will be confirmed approximately ten <br /> days atter 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. Anew application <br /> may be submitted when the fila 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EMD M Se 100W PUBLIC RR11116 111W"I'M <br /> ** TOTAL PAGE.01 ** <br />