Laserfiche WebLink
� - PAGE 01101 <br /> r <br /> 10/22/2010 08:46 92574660 :AEI CONSULTANTS <br /> EHQ LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH.DEPARTMENT <br /> (I I_;; L 2 2010 604 East Main St:Stockton, CA 95202-3029 <br /> ENVIRON �s��a�l t�Phone: (209)468-3420 Fax. (209) 464-0138 Web;www.sjgov. rgleh <br /> _pF T V1G.E; PUBLIC RE D-RA--RELEASE-APPLICATION <br /> r <br /> APPLICANT:,,yV / BUSINESSIAGENCY:_� 5-0 <br /> G <br /> h ADDRESS: y La'm11,0 lake ) _ CI'MISTATE1ZIP: :WM1 Vf` CU-IL-K Cj�_RL4._ <br /> PHONE(1): V(255)_714(o-(v0Qg ' PHONE(2): M5 � FACSIMILE: (RZ <br /> TENTATIVE'APPOINTMENT DATE: Time; <br /> (Ploaae allow 10 buslness days from data of applicati*fi submittal-"Tentative only-must be confirmed) <br /> E]CHECK BQX TO EXPEDITE RE ST-S115 FEE(C SH OR CHECK ONLY.)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN P YLA 5:b u-t DATE (0-1-2.7— <br /> Electronic <br /> Z.ZElectronic Information: ❑List Map--Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br />'� 1YP.rl�l�ri f� c7f` ''�D�, Y7 SoZ - <br /> z. lDOaSfiT" rtrlrl � Unite <br /> 4. (7 vUnit 3 <br /> 5. <br /> 4 <br /> a. <br /> Unit B <br /> Specific Date Range of Information Requested; From ib <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®IJWXRGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT SOLID WASTE FACILrFY1VEHiCLE <br /> ®OTHER CLEANUP SITE(NON^LOP) FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORINWRtmovAL) d DOG KENNEL DAIRY <br /> HAZARDOUS WASTE VENERATOR CHICKEN RANCH WASTRHATER TREATMENT PLANT <br /> TIEMD PERMITTED FACILITY MOTEUHOTEL PUMPERTl2UCK1YARD1CHEtAECAL TOILETS <br /> �]TATTOQIBODY PIERCING []PCJOtISPA LANE)USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY <br /> . Q OTHERPLEz4SE SPECIFY) <br /> ) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Atli-5:00PM(EXCLUDIN. H2 jDAYS <br /> 1. last klb tQ On addresses in the space above. Select the type(s)of files fr�rn the list above by checking the appropriato <br /> box(es). At least one the type MUST,be selected. F 09 40. r m411 tp th dre iCa above. Address <br /> E ranges will not be accepted-for additional assistance with file addressee,contact the EHI?. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant It any END files exist.-An appointment f r review will he confirmed approximately ten(1 t7) <br /> days after receipt of application. The files will be held far a maximum of I ive business days for review. Appolntments <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 applicatlan maybe <br /> submitted when the file is available. <br /> 4. Any file net returned in the same condition as released will'be reorganize by EHD staff at the axpense of the applicant. <br /> Future file reviews by the same applicant may require a•S115 depd!§it prior to review, <br /> S. If you naed further assistance,please contact Diane Martinez,at(2D9)468L3425. . <br /> EHD USE ONLY <br />{ <br /> VA)4s-as <br /> wawa <br />