Laserfiche WebLink
I <br /> INFO RECEIVED <br /> 2011 S N JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRON ENTAL HEALTH DEPARTMENT <br /> ROE MENTAL I M.TH 1868 East Haz Iton Avenue, Stockton,CA 95205-6232 95(90Z? <br /> PEWAITISEFi Iii Telephone:(209)468-341 0 Fax:(209)46rg/ohd <br /> 4-0138 Web:www.sjgov,o <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: t, f for : �, - <br /> _ BUSiNESS1AGENCY ��h�r �.,g'��e .,wK `>r,cn�� <br /> ADDRESS: w c.11111G, o $t CITYISTATEIZIP: <br /> PHONE{1}; O PHON (2); qj 3 L2365 _FAX OR E-MAIL: �yylar .1 s <br /> Please allow 10 business days from date of application submittal for the records to be available. Lo <br /> Staff will contact you to arrange an i appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE tEQIJ STA$139 FEE[CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 7- <br /> 1. List up to ten addresses In lected space below. Sel ct the types)of files from the list below by checking the appropriate <br /> boxes}, At least one file t e MUST be seFax to(2091 464-0138 or mail to the address indicated above. Address <br /> ranGyeS will not be accepted.Applications receiv d after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and cont-nt of EHD records,please contact EHD at the number rioted above. <br /> 3. 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 /> 4. Any file not returned in the same condition as re�eased will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may ri I a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAB E FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map—Des6ription: <br /> Specific Date Range of Information Requested: Frim to <br /> iENI(IRONMENTAL <br /> HEALTH DEPARTMENT Fl 1E ADDRESS ' <br /> FILES WWD�M8i E ONLY <br /> UNDERGROUND TANK(LISTS Street# Street Name City <br /> CLEANUP SITE(LDP} <br /> OTHFR CLEANUP SITE(Nim-LOP) <br /> X1 •� 7� <br /> )r �L <br /> HAZARDOUS WASTE • ❑DAIRY <br /> `r ®TIERED PERMITTED FACILITY 2 r l_ <br /> PTAROVEGROUNb TANKIN �� �. /'W. Zf �hy �4y, ��• <br /> UST (MONITORING I REMOVAL r A1C, W <br /> PS <br /> HAZARDOUS MATERIALS ' , V l G�(A E:T �")(tiy 40 Gk'` ❑ <br /> SPIWRELEASE RESPONSE <br /> '0 <br /> SOLID WASTE FACILITY 1 VEHICLE 4 No M WATER QUALITY <br /> [�FOOD FACILITY �V�� L� U�o. �GJ' �/enr 1�• �Oh 1V0 t� 1 Wl�7f / <br /> POOL i SPA <br /> A � �0/�q 4 T SS <br /> r7 DAIRY 5 4"A L45-T- i <br /> A <br /> LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK I •+- <br /> YARD!CHEMiCPI-TOILETS <br /> WASTEWATER TREATMENT PLANT / • • • CUPA <br /> ❑HOUSING ABATEMENT L^��� ��� 1�r It" 4 �.l <br /> rs •IkD+- �OY, <br /> MOTELrH07EL <br /> ❑CHICKEN RANCH I DOG KENNEL 6 lJr 1 TI.Ji lr W��'lQ.�ly�.` 1 W-! 4'�1 •�V� •D` J4 Cl1PA-UST <br /> ❑MEDICAL WASTE FACILITY l$]� J �� <br /> TATTOCBODY PIERCING } l �j <br /> COL40 1i <br /> Ej MTii PLAINT B lat0 {L. �r„}N.1 � �y\ a + ��Z�1'lR✓. SOLID WAM <br /> COMPLAINT CCCJJJ i .,O W �1�C <br /> OTHER(PLEA$E SPECIFY): }Q / `- i� -�.-- ____ IY'� � q �q�tou�� <br /> 16 LOT- PI2o o)u p 61 2 <br /> `@9X€DARER-EMS USE 0n1LY"• �✓ <br /> CIO M �Fir — <br /> ❑ Records provided by Staff-PPR Complete. scoff name, _ <br /> FHP 48-46 <br />