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-' .' � <br /> R � �= =~ snomswum��E �^�' SAN ]OAQU|NCOUNTY <br /> D�� - � 90� �� <br /> ENV|RQNMENTALEALTH DEPARTMENT--- 1868 East Hazelton Avenue, Stockton, CA <br /> ' ' <br /> Im�eoh�Da: (yOQ\4O8-342OFas� /?OS\4O4-013RVVeb' Vwww 'gnvoroA�hd ~ ° <br /> ��NV'F](l � ` `- ' `-' ' ' �� � °�- <br /> � —�� PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESS/AGENCY: <br /> ADDRESS: CITY/STATE/ZIP:- Z' <br /> P|aooe allow 1Obusiness days from date ofapplication submittal for the records tVbaavailable. <br /> ^ \ ° <br /> Staff will contact you b}arrange aOappointment date and time tVreview the requested records. <br /> F-1CHECK BOX ToEXPEDITE REQUEST'SIA��ss(CASH onCHECK ONLY) REQUEST PROCESSED|waBUSINESS DAYS <br /> SIGNATURE OFAPPLICANT DATE <br /> LElectronic Information: 0 List 0 Map Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city Unit I <br /> hl <br /> Unit 3 <br /> 5. <br /> 6. Unit 4 <br /> 7. <br /> 8. El Unit 5 <br /> 9. <br /> 10. UnjtLj6 <br /> Specific Date Range of Information Requested: / <br /> From to <br /> ENVIRONMENTAL HEALTH DEPAIRTMENT FILES <br /> T-AN�:T§R-CLIEANLLP=$jjF_jLgP)_ MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE <br /> P4� __xE(NG)N-L0P-)- HOUSING ABATEMENT WASTE TIRE 10 <br /> [9-tJ-NDERGROUND TANK(MONITORINGIREMOVAL) El FOOD FACILITY El DAIRY V"n I[ 3. P`-� <br /> L3,*99VE-(�TANK [:1 CHICKEN RANCH/DOG KENNEL []WASTEWATER TREATMENT I'LANT <br /> EJ'WAZARDOUS WASTEMAZARDOUS MATERIALS 0 MOTEL/HOTEL E]PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> R:T-'IERED-PERMRTSD_EAQILITY D POOLISPA El LAND USE APPLICATION SITES <br /> COMPLAINTIRESPONSE RECORDS F-I OTHER(PLEASE SPECIFY) <br /> VVsLLomoSEPTIC PERMIT RECORDS AVAILABLE RMONDAY—FRIDAY 800AMO <br /> Y. List uD to ten addresses inthe space above. Select the typo(s)of files from the list above bychecking the appropriate <br /> box(es). Atleast one file type MUST boselected. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance inidentifying the nature and content ofeMDrecords,please contact E*oatthe number noted above. <br /> 3. The EHOwill notify the applicant ifany EHOfiles exist. Anappointment for review will beconfirmed approximately ten<1U> <br /> days after receipt ofapplication. The files will be held for a maximum of five business days for review. Appointments <br /> should bpscheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be re organized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. ***BOXED AREA-EHD USE ONLY' <br />