Laserfiche WebLink
EHD LOG NUMBER <br /> o vED `USAN JO <br /> AQUIN COUNTY <br /> EIVE® MENTAL HEALTH DEPARTMEPM'� <br /> E ( 45P <br /> ENTAL <br /> 600 East Main St.'Stockton, CA 95202-3029 <br /> OCT 2elephone: (209) 468-3420 Fax: (209) 464-0138 Web: www:sjgov.orgle <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ED MACDANIEL BUSINESSIAGENCY: PARTNER ENGINEERING <br /> ADDRESS: 3210 GOUGH STREET#105 CITYISTATEIZIP: SAN FRANCISCO, CA 94123 <br /> PHONE (1): 415-240-3205 PHONE (2):__ FACSIMILE:415-707-203$ <br /> TENTATIVE*APPOINTMENT DATE. _ _ Time: <br /> (Please allow 10 business days from date of applicaficr ;i amitta -*Tentative only-must be confirmed) <br /> E] CHECK BOX TO EXPEDITE REQUEST-$1,. .: `:,_i fi.-H OR .h Ec; ,'O' LY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT /T DATE 10!2712010 <br /> Electronic Information: ❑ List ❑ Map -- Description: <br /> i <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. aOD MARINERS DR. STOCKTON i <br /> 2. 3555 WEST HAMMER LANE STOCKTON nit 2 �1 l <br /> 3. (y1' r g I <br /> 4. nit 3 <br /> 5. <br /> 6. R4 <br /> 7. <br /> 8. <br /> ❑ unit 5 <br /> 9. - <br /> 1 D. <br /> nit 6 <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ® UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ®SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ®WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ®HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ®WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKWARDIC HEM[CAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLlSPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ®OTHER(PLEASE SPECIFY) WELLS(WATER&MONITORING)&SEPTIC <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:DOPM(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 appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the.EHD. Applications received after <br /> 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 approximately ten (10) <br /> days after receipt of application. The files will be held for a maximum of five business'days for review. Appointments <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 application may be <br /> 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 applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> EHD USE ONLY <br /> EHP 48-06 <br /> 07!?9198 <br />