Laserfiche WebLink
05/14/2007 10:40 FAX U002/002 <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Rax:,(209)464-013&Web: www.sjgov.org/e <br /> t, <br /> 61� PUBLIC RECORDS RELEASE APPLICATION i, <br /> APPLICANT: �Diill��DS BUSINESS/AGENCY:' <br /> ADDRESS: r f 9AL4M� (.�( s <br /> , „I "� 21l. _ <br /> PHONE(1)::(�, n)23y` PHONE(2): FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time. <br /> (} (Please allow 10 business days from date Map.plication submittal-`Tentative only-must be conffnen us <br /> CHECK BOX TO EXPEDITE R=ASH 60 F CASH O CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> ��SIGNATURE OF APPLICANT DATE f P �- <br /> ..X1 UNIT DISTRIBUTION f ❑ uni © Unit 2 O Untt 3 M Unit 4 C3 Unit 5 ❑ Unit 6 ❑ Other(electronlchiststmaps) <br /> FILE ADDRESS EHD USE Ni.Y <br /> Street# Street Name i city <br /> _� x{100 - FR+r+�QrlT .->- +=•t- ;Sock_ or_s .2-s5O 35� - <br /> 2 <br /> - `{ - l`!• .L ILLt4rc {�•!� STac to ... 1v.F. <br /> 5{vc t-ov+ <br /> l <br /> 4• _.i. 50 E..C� -p.w .r- Rd 5#b�k�ati~ _ W FI <br /> 1-- <br /> 516 A <br /> 6. - ' <br /> 7. <br /> 8 ' <br /> if <br /> Ll 0 <br /> Specific Date Range of Information Requested't%_""`' t � � s <br /> ENVIRONMENTAL HEALTH D114AQ0I <br /> '�UNDERGROl1N0 TANK(UST)CLEANUP SrrE(COP) Q HOUSING ABATEMENT Q$OLIO ASTE FIL_IlY EHiCLE .1 <br /> ROIHERCLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> i—KVNDERGROUNd TANK(MONITORINGIREMOVAL) ❑DOG KENNEL - ❑DAIRY <br /> AHAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH - ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEUMOTEL ❑PUMPER TRUCKlYAROICHEM TOILETS r <br /> TATTOO/BODY PIERCING ❑POOLISPA 0 LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE.SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-S: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 ! <br /> appropriate box(es). At least one file type MUST be selected. Faxto-L2o9L41i4-0138 o 'mail to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with filo addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. I <br /> 2. The EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed r <br /> approximately ten (10)days after receipt of application. The files will be held 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 staff may not be immediately available for review. A new <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. " 5 <br /> a <br /> END 4"2-006 - <br /> 1li4l03 <br />