Laserfiche WebLink
DATE RECEIVED 0 0 EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL 11EALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ZP7 0 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: env BUSINESSIAGENCY: Mr f2 jyiJ—/M1 <br /> ADDRESS: ;V95 /goiF I/D YPYDf(f r Pl/Qfltj7t 7�f 1 �Q�� brrl./Gt ��5 3 <br /> PHONE(1): L-zS- _612- -4LO X q 1 PHONE(2): ?--�5-i2,,5d ­236 �Ce/l) FACSIMILE: �',.75 -t✓O 0.a <br /> TENTATIVE*APPOINTMENT DATE: dwI/ltil.,.3,-?no-�' Time: /09t1 <br /> (Please allow 10 business days from 4fate of appfication submittal-`rentative only-must be confirmed) <br /> E3 CHECK BOX TO EXPEDITE REQUEST-$95.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � �G/ ��t t�G� _� DATE 6!1<��oC� <br /> Electronic Information: El List❑ Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City ❑ Unit 1 <br /> 1. So CGtartl�r VI' ,� <br /> 2. /S r t'tr w fl,V4,c/Y� ❑ ung z <br /> 3. 4 q 0 W a4rw J'jckm_ <br /> r£` Unit 3 <br /> 4. hF`f W4 <br /> � � • ,- Unit 4 <br /> 7. <br /> ._ ElUnit 5 <br /> 8 <br /> oe <br /> 9. <br /> Unit 8 <br /> % <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,d UNDERGROUND TANK(UST)CLEANUP$ITE(LOP) 0 HOUSING ABATEMENT �1�6LID WASTE FACKJTY1VFHICLE <br /> .r OTHER CLEANUP SITE(Nowl.OP) 0 FOOD FACILITY 0 WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTEUHOYEL 13 PUMPER TkucKNARDICHEM TOILET$ <br /> 0 TATTOOMODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION SITES <br /> t3 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SE;MC PERMrr 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)464-0133 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 /> Z. 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 file 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$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD48d$ 9It3l20� <br /> TO 39Vd Hd 9NIi133NIDN3 DI13 aZkVZ099Z6T Z0:60 9092/ZT/ZT <br />