Laserfiche WebLink
04/24/2007 08:56 5302445021 LAWRENCE ASSOCIATES PAGE 01 <br /> DATE RECEIVED -- FHD LOG NUMBER <br /> SAWN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E. Main Street, Stockton,CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.Sjg0v,org1 d <br /> PU13LIC RECORDS RELEASE APPLICATION <br /> APPLICANT! USINLS AGENCY: <br /> ADDRESS:--2,00t MAr � <br /> PHONE(1): ���0.—.Z`[�{— D PHONE(2): FACSIMILE: lJ ~2-.q <br /> TENTATIVE`APPOINTMENT DATE. Jr 307 TA.; edw'aAt-q <br /> (Please allow 10 business days from date of appl cation submittal-'TevolvVe iuca he confirmed) I7 ` <br /> CHECK BOX TO EXPEDITE REQ ST-$95. CASH OR CH L F); ROCESSED IN 3 BUSINFSS DAYS C--J-,AC bje_ <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information; ❑ Lis Map-Description: <br /> - <br /> FILE ADDRESS EHD USE ONLY <br /> Streit iF l�_$treet Name city ❑ Unit t <br /> 1. I O c <br /> 2. 10 4s 1Unft 2 <br /> 3. <br /> 4. p—ILA)0 �1 Unit 3 <br /> Unit R <br /> 6. cb 5-0 <br /> 7. cI lU <br /> ❑ Unit 5 <br /> 10. 1 A <br /> fl-c-0, 5o. fflJa t,�. { 1�.,rYr ."�'�yS. f 1' +H, � � - <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT OWSoLIo WASTE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON4-OP) CI FOOD FACILITY Z WASTE TIRE <br /> XUNDERO <br /> ARUNo TANK(MONrrOR(N0tREMOVAL) 17 Doo KENNEL X"AIRY <br /> HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH 2rWASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATrooIBODY PIERCING 0 POOL/SPA ❑LAND SE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY )ZI OTHER(PLEASE SPECIFY) 4 , df T an'K. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 0:00 AMS:OOFM - EXCLUDINO 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-(208)464-0138 or mail to the address indicated above. Address <br /> ranges will not he 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 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$9S-00 deposit prior to review. <br /> LHn USE ONLY <br /> EHD48-M DMW2666 mn <br />