Laserfiche WebLink
DATE RECEIVED EHD LOG NUMBER <br /> SAN ,JOAQUIN COUNTY <br /> ENN __.ONMENTAL HEALTH DEPARTN..,NT <br /> 600 East Main Street, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: 3q q <br /> e <br /> /� PUBEE <br /> LIC RE' RE, APPLICATION <br /> APPLICANT:_ AlecUS SO 1-4;- BUSINESS/AGENCY:/0t',4'a_-_v f //. RoLC- s Agoe- <br /> ADDRESS: lQy SROCL. DZ f✓Lye-41 r4d-- D� CA 9j6q 2 �— <br /> PHONE(1):5-10 (o 3 o//:? PHONE(2): ,530 4 3 3 - o/I? e FACSIMILE: S4 X <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> CHECK (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> BOX TO EXPEDITE R $98.00 FEE(CASH 0��ee HECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �t�GYc� �dJ�- DATE 05 oT/2ao >7 _ <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 1• J z25 Lo ck -QR <br /> 2. ❑ Unit 2 <br /> 3. Obs <br /> ec <br /> 4. <br /> 5. <br /> 6. <br /> 7 Ll•,Unl <br /> 8. <br /> ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> � DERGROUND TANK(UST)CLEANUP SITE(LOP) 11 HOUSING ABATEMENT 1:1 SOLID WASTE FACILITYNEHICLE <br /> �Y OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑WASTE TIRE <br /> DERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOO/BODY PIERCING ❑ POOUSPA ❑ 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 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 $98.00 deposit prior to review. <br /> EHD USE ONLY <br /> *** If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br /> EHD 48.06 9/14/2006 <br />