Laserfiche WebLink
MM(XIVEty No, 0410 P, 1/1 <br /> r DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> EG 0 11ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 0NVMN4 MI_ALIHR LTH Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> firllTfi 'l..E� PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; v(�o k3USINESS/AGENCY: ��s 11�tJlro,�me�l <br /> ADDRESS: 1• �re2 � �,. � �-j CITY/STATE/ZIP:�y�/ty�,�,T <br /> PHONE(1): SIO- I'I'7-1$t3,S` 0 PHONE (2); - . '},j yg16 FAX OR E-MAIL: A PQW p�a,s, 6r,7— <br /> Please allow 10 business days from date of applicatfon submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> HECK BOX TO EXPEDITE RE-QU T W F (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1-1—1`7 <br /> 1. list up to ten addresses in the sprce below_ Select the type(s) of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected, rax to(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD flies exist. An appointment for review will be onflrmHE <br /> p�Mt�ntq�( <br /> days after receipt of application. The flies will be held for a maximum of five business days for re �jp, re <br /> should be scheduled accordingly. <br /> 4, Any file not returned in the some condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Puture file reviews by the same applicant may require a$139 deposit prior to review. 0r 1 <br /> WELL,AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) f <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From LEto <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> UNDERGROUNDTANK(UST) Street# Street Name city /16A <br /> CLEANUP SITE(LOP) 1 ^' ^ \/•; ❑CONSUMER <br /> OTHER CLEANUP SITE(NON-LOP) 96& S L `'\1(�� IS", <br /> ( , S� ,/' <br /> HAZARDOUS WASTE <br /> DAIRY <br /> TIERED PERMITTED F=ACILITY <br /> t5[TABovroROUND TANK <br /> J�--'- ST (MONITORING/REMOVAL) p 1\ A 1 /� 3 ❑PWS <br /> A7ARDOUS MATERIALS D Com}-,1,`,1)��, IW\ J\� <br /> SPILURELEASE RESPONSE I <br /> l r r <br /> U <br /> OLID WASTE FACILITY/VEHICLE A WATER QUALITY <br /> FOOD FACILITY A`F '•'ll('1//-� <br /> F]POOL/SPA ;�•'Oj� / M <br /> �O ^ NK—ITE M11'I�YIQ"1 <br /> 11, <br /> DAIRY 5 <br /> AND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK/ ❑Houma <br /> e <br /> YARD/CH EMICAL TOILETS <br /> r <br /> WASTEWATER TREATMENT PLANT <br /> F]HOUBING AaATEIAENT 7 <br /> I]MOTEL/HOTEL 1 <br /> ❑CHICKEN RANCH/DOG,KENNEL ^ UPA-UST <br /> MEDICAL WASTE FACILIY <br /> Il TATTOQ/BODY PIERCINQ N n-J <br /> kWASTETIRE r V SOLIDWASTE <br /> e (� <br /> /KLCOMPLAINT <br /> I]OTHER(PLEASE SPECIFY): ❑ACCOUNTING, <br /> iD <br /> y "'�OXRP ARPA-RHP USR ONLY"'® 1 �y <br /> OR,-V e- . <br /> LI Records provided by Staff-PPR Complete. Staff Noma; <br /> Received Time Aug. 1, 2017 2 : 59PM No, 2016 <br />