Laserfiche WebLink
EHD LUCK NUMHrK <br /> RECEIVED SAN .IOAQUINC088H '°N Wd�,,,:l4 EL06 '� dag awil paniaaa� <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SEP 5 2013 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www_sjgov_org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ",L 116,G,i BUSINESS/AGENCY; AFT Coz,Sa�+ati.�5 <br /> ADDRESS: U Cavi orb �'►n��.(/i CITYISTATEIZIP:(.)al,,kr r(Y K.&A f 9gS9ti <br /> PHONE(1): �9Zr,�1 t�Fi�OQp PHONE (2): FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data of application submittal-"Tentative only-roust be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT, okVjf DATE 9 f �20i3 <br /> Electronic Information: ❑ List[] Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 2. Soo � ":�. 5T � f�� _ T C Unit 2 11Y� <br /> 4. .(Unit 3 <br /> 6, - Zli-S L¢/t lo�lS� (26nit4 <br /> 7. <br /> wiv- <br /> 8. / ❑Unit 5 <br /> 9. <br /> 10. 0 Unit 6 <br /> Specific Date Range of Informadon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILIIYNEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> �1NDERGROUND TANK(MONITORINGIREMOVAL) F1 FOOD FACILITY []DAIRY <br /> � <br /> 4VAZARDOUS <br /> OVEGROUND TANK []CHICKEN RANC01 DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> WASTEMAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑pOOL1SPA El LAND USE APPLICATION SITES <br /> E-1TATTOO/BODYPIERCING ©'COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. Ust up to ten addresses In the space above. Select the type($)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)4.64-0138 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 /> 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 behold 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$125 deposit prior to review. XEG'yAF3 !lMuiiai5i`ar„iriia" <br /> -_.,... : .moi•. _ - - - - <br /> EL <br /> r.. ,i. .•-...-.. :.::i..-,n a;....,•w,"51• .it:.f...:.: - .,ul ,.h-::..y <br /> : <br /> / . <br /> -- — — u <br /> 13 <br /> ..FM1:te <br /> `S <br /> - <br /> - a <br /> e <br /> EHD 40-06 El <br /> ❑ ❑ <br /> 7Li/TGI -4nt-)_4 QINHi-intz n') T'-IH CCMQQb1n7C nT•TT CTn7Fr.nICO r! <br />