Laserfiche WebLink
a <br /> SAN JoaQLZN COUNTY <br /> ENVIRON]VIENTAL HEALTH DEPART' ENT <br /> AUG I2005 304 East Weber';Avenue, 3`�Floor, Stockton,CA 95242-2708 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjgay.argfehd jq313 <br /> i II fix. <br /> ENVIRONMENT HEALTH � 4 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: l.s'f t,'i �"^ A��� k F, I BUSINESSIAGENCY: - <br /> ADDRESS:_ <br /> PHOidE(1}: q.�7 Ceee'4— �o� r 1 PHONE(2a: T 77 f 'Ca�`�-'C�SaY ^FACSIMILE: Z� �•�o�—9 <br /> TENTATIVE"APPOINTMENT DATE, Z� ` ZsTime: 07 0� <br /> .. (Please allow 10 business days ifom date of application submittal•'TeataUn only-must be confirmed) <br /> CHECK BOX TO EXPEDITE RFQUEST!$9].00:FEE((CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3USINESS DAYS <br /> SIGNATURE OF APPLICANT �Jl — A,& 1DATE <br /> UNIT DISTRIBUTION 0 Unit 1 ❑Unit 2 0 Unit IX Unit El Unit 5 ❑ Unit 6 L7 Other(electronicliistslmaps) <br /> FILE ADDRESS I EHD USE ONLY <br /> Street 9 Sheat Name !: —TF city <br /> q5'2 krZ2. 4444-1-S E Ma..•. IL"e, Ji .1: c K a <br /> 4. Z2e)S E F,t k—%,a,ti S-r.l li :R i S <br /> 6, S 41C ^ <br /> • ledAd In Yh <br /> 10. ZJ-57L e. MQ.rC q:I AtA 5 G <br /> Specific Date Range of information Requested;From 2r��3 to <br /> ENVIR6NMENTALHEALTH DEPARTMENT FILES Ci <br /> y..)kt-iomr.ROUND TANK(UST)CLEAITE Nup S (LOP) �! � ❑Homim AeATEMENd T SOLID WASTE FACILITYfVEFffCLE C7 OTHER CLEANUP SITE(NON-LOP) 13 F000FACILITY 0 WASTETIRE -Y/J <br /> O UNoERGRDUNDTANK(MONITORINGfREIAOVAL) E3 Dor.KENNEL M DAIRY <br /> �+iAi'JMRBfl1l6rY7�3'IE a IdMTDR 4D40"Mmipow/ON - -An k*" MIl'El r4WK&W*%ANT <br /> 11 ill` <br /> C3 TIERED PERmrmo FACILnY t3 MOTELMOTEL O PUMPER TRUCK[TARDfCHEM TOILETS <br /> 0 TATTODIBODY PIERCING fl PWLPSPA ❑LAND USE APFLICATION Sims <br /> Ca MEDICAL WASTE FACILITY "r ' b OTHER(PLEASE SPECIFY) <br /> h II' <br /> WELL AND SEPTIC PER6IIY RECORDS ARE AVAILASLE FOR REVIEW- MONDAY-FmDAY3.00 AM4:00PM EXCLUpNG 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 <br /> appropriate box(es). At least one file type MUST be selected. Fax to1209)464-0138 or mail to the address <br /> indicated above. Address ranges will hot be accepted–for additional assistance with file addresses,contact <br /> Me EHD.Applications received after 13:00 pm will Ve processed the next business day. <br /> 2. The EHD will notify the applicant if arry.,E )files exist An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application . The files will beheld for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD stal may not be immediately available for review. Anew <br /> application may be 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 <br /> applicant. Future file reviews by the'same applicant may require a$93.00 deposit prior to review. <br /> EHD 49.62-06 l <br /> 1F�aro5 ij . .. <br />