Laserfiche WebLink
SAN JOAQUIN COUNTY v <br /> ENVY.JNMENTAL HEALTH DEPARTAi<NT <br /> 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> r PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: +.t F 2'bcb c BUSINESS/AGENCY:_-W1IG.cc- <br /> 1Assoi,.a�e� <br /> ADDRESS: IgIO VII. ��cw�µ,tr ANL Sµ�}La F SijckrA cA <br /> PHONE(1):. 2C`)- 234-7? Z PHONE(2): FACSIMILE: 209 -23'I` 77 Z 7 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> X (Please allow 10 business days from date of application submittal-`Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE RE QU -593.00 F E( H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE -7 I3 <br /> UNIT DISTRIBUTION ❑ Unit 1 ❑ Unit 2 ❑ Unit 3 ❑ Unit 4 ❑ Unit 5 ❑ Unit 6 .0 Other(electron ic/Iists/maps) <br /> FILE ADDRESS _ <br /> Street# Street Name City HD USE ONLY <br /> 1. 11 LAO W, Hemet=,rGk <br /> 3. I k+o <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. — <br /> 9. -- - <br /> Specific Date Range of Information Requested: From to Roms} <br /> -ENVIROIVIII�EiVTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELJHOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PIERCING ❑ POOLISPA ❑ 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-5:00PM - 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. Fax to (209)464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses, contact <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 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. <br /> EHD 48-06 <br /> 1114105 <br />