Laserfiche WebLink
NOV-19-2014 WED 02:21 PM KLEI*LDER FAX NO. 8i#13306 P. 02 <br /> RECEIVED <br /> . EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> NOV 19 2014`/ <br /> - ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENTALHF�LTH 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PERM1TISVy phone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY: yE, �Grn6r2 <br /> ADDRESS: ¢est «o D amao CITYISTATEIZIP: -54e--r 44<6 eqzl+r' <br /> PHONE(1): c1 PRONE (2): - -ZS FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST•$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT A DATE - >/ <br /> Electronic Information: ❑ Llst lig Map—Descriptlon: r <br /> FILE ADDRF-55 EHD USE ONLY <br /> Street# Street Name City M Unit1 <br /> 2, �i1tlunit2 ,C <br /> I <br /> 3. z7G <2e Teams �t,, <br /> 4 0-A <br /> G Got <br /> unit4 <br /> 6• 72/tGd A V n/ �Q G� oG' <br /> 7. <br /> B- S rYS L.A¢GN Cz-;p 2AG ❑unit 5 <br /> 9, <br /> Unit 6 <br /> 10. <br /> e <br /> - 2E 1�'V <br /> Specific Date Range of Information Requested: From i k SID to =---- — <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(LIST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ®SSouD WASWASTE TE FACILnYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) E]HOUSING ABATEMENT O DAIRY <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) Q FOOD FACILITY El <br /> TREATMENT PLANT <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ®PUMPER ATER TR A TREATMENT <br /> PKAT TOILETS <br /> ®HAZARDOUS WASTEIHA2ARDOUS MATERIALS ❑MOTELIHOTEL ❑©LAND USERUCKICATIDN SITES <br /> TIERED PERMITWO FACILITY ❑POOLISPA Tal <br /> ❑TATTOOI9oDY PIERCING ®COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uo to ten addresses In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> bax(es). At least ane file type MUST be selected. Fax to 2091464 0138 or mall to the d ass in Gated above. Address <br /> ranges will not be accepted,Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD files exist. An appointmentfor review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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 raviews by the same applicant may require a$130 deposit prior to review. '^BOXED AREA•EHD uSE oNLY— <br /> ❑ Records provided by Staff-PPR Complate..StaffName: e�je117a <br /> EHP 4"S <br /> Received Time Nov. 19. 2014 1 :34PM No, 7594 <br />