Laserfiche WebLink
From:Marcus H. Bole & Associ. 530+633+0119 1210 109 16: 12 #140 P.001 <br /> (� ❑� EHD LOG NUMBER <br /> SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> i..�1. Q 7 2009 T� 600 East Main Street, Stockton, CA 95202-3029 <br /> ENVIRONMLNT HEALTf lephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.o <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION// p �F <br /> APPLICANT: ''c l-' BUSINESS/AGENCY:, /�C�r<="✓i ��i"�� ' <br /> ADDRESS: /G�y roc/� �l/�'� City/State/Zip l�lellz /1-1, <br /> 1-kw id <br /> PHONE(1): . c5� _�� ���� 7 PHONE(2):,.5— 6c FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: !�, �/Z 7—hu-% Time: 9"-3 <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 2Zi��;2: �ZLZ f Le-4 DATE /T/le) <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name �— City ❑ Unit 1 <br /> D <br /> 2. n L" /� �/. e ❑ Unit 2 <br /> 3. JV -4. <br /> 4. Glu t 3 <br /> 5. ' ' /r `"' J ❑ Unit 4 <br /> 7. <br /> 8. <br /> 9. , <br /> / unit s <br /> 10. D Al� <br /> Specific Date Range of information Requested: From to <br /> //. n ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,., NDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE <br /> C.,'UOTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 13 WASTE TIRE <br /> Q'tf ERGROUND TANK(MONITORING/REMOVAL) 13DOG KENNEL 0 DAIRY <br /> A7ARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> 1:1 TIERED PERMITTED FACILITY 0 MOTEL/HOTEL M PUMPER TRUCK/YARDICHEM TOILETS <br /> Q TATTOO/BODY PIERCING 0 POOL/SPA 13 LAND USE APPLICATION SITES <br /> •MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:OOPM - 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 48-06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />