Laserfiche WebLink
08/14/2007 10:40 FAX �.. � 002/002 <br /> �;. 4 i EHD LOG NUMBER <br /> 5 f 11 f , SAN JOAQUIN COUNTY <br /> ENVIRO' NMENTAL HEALTH DEPARTMENT <br /> �} 304 Fast Weber Avenue 3r1 Floor Stockton CA 95202-2708 <br /> w 1`t 2 Yl Telephone-(209)468-3420 Fax:(209)464-0138 Web: www.sjgov.org/e <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> Pi;., „- f <br /> APPLICANT. I -BUSINESS/AGENCY: <br /> ADDRESS: j� ,ki 9AM a <br /> PHONE(1): ��`t`��Z'L <br /> PHONE(2): FACSIMILE: Z3`(` 2� <br /> J TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please aflow 10 business days from date of application submittal-"Tenfative only-must be con e <br /> CHECK BOXTO EXPEDITE REQUEST_- .00,F CASH O CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ` <br /> _y DATE � I a <br /> UNIT DISTRIBUTION. ii ❑ Uni ❑ Unit 2 :;fa Unit 3 ❑Unit 4 Cl Unit 5 ❑ Unit 6 ❑ Other(electronlellistslmaps) <br /> FILE ADDRESS; EHD USE NLY <br /> Street# Street Name City # <br /> 1 I o O <br /> 2. +-{ �. rri i.i.s.4r� A;�(4: ;S S•i-ac.tc.�r�-' ... �t1,_F,F� <br /> 3' <br /> _- ..... . __.._....i.E. tRo <br /> 4• i550 <br /> r3j yS° Ajpt l�aovn_ � <br /> - <br /> r. <br /> 1� <br /> C <br /> 7. <br /> 8. <br /> Y# <br /> =' <br /> Specific Date Range of Information Requested: o,,. t07 <br /> r` <br /> ENVIRONMENTAL HEALTH D <br /> ;.r <br /> 'tr UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSSNG ABATEMENT Q SOLID ASTE F CICITI'1VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) :�L in FOOD FACILITY 0 WASTE TIRE -' '- <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) O DOG KENNEL ❑DAIRY <br /> .XHA7ARDOUs WASTE GENERATOR "Q CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> C1 TIERED PERMITTED FAciuTY t_i;Cl MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> 171 TATTOOIBODY PIERCING POOLISPA .� ❑LAND USE APPLICATION SITES <br /> p MEDICAL WASTE FACILITY I ��D 01-HER(PLEASE SPECIFY) p <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-5:00PM - E%CLUDING HOLIDAYS. �+ <br /> 1. List up to ten addresses In the space{aborie. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one flle,type MUST be selected. Fax,to(209)464-M38 or mail to the address <br /> Indicated above' Address ranges will not be accepted—for additional assistance with file addresses,contact t <br /> the EHD.Applications received after 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 <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 onlby EHD staff may not be Immediately available for review. A new <br /> application may ibe submitted when the file is available. <br /> 4. Any file not returned in the same conditlan'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 /> f: <br /> eHD 48-02-006 <br /> 1114/06 <br /> i <br /> i <br />