Laserfiche WebLink
M"MM EHD LOG NUMBER <br /> ;r v SAN JOAQUxN COUNTY <br /> ENVIRONNfICNTAL REALTH DEPARTMENT <br /> U C I," 304 East Weber Avenue,3d Floor, Stockton,CA 95202-2708 <br /> EIdV1rR0N%,,1ENT HEKIKTelephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ebd <br /> PES 4i,'j-i;SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: AP-i C���//1I,W 1) [1Y2 r, BUSINESS/AGENCY: Q���C�(�C COWULrWU <br /> ADDRESS: <br /> PHONE(1): �,(D—iY�3 �a� PH NE{2): � Tl "'� f�0 (n CSIMILE: M—td2—41:�J <br /> TENTATIVE"APPOINTMENT DATE: L AM Time: -3 a gaw <br /> (Please allow 10 business days from date of application submittal-"Tentat/ve only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQU T-$93.00 FEE(CASR CHECK ONLY)+REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I <br /> UNIT DISTRIBUTION ❑Unit 1 ❑Unit 2 ❑ Unit 3 ❑Unit 4 ❑Unit 5 ❑ Unit e O Other(eleetronic/llsts/maps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Nano City <br /> Of--(�' 3. � <br /> ° p✓Nti '7 f YJL p <br /> 1A)LOS f 0 WOOF <br /> 6. <br /> 7. V/ <br /> 8. <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILIES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> 1�OTHER CLEANUP sR'E(Notm-op) ❑FOOD FACILITY 0 WASTE TIRE <br /> h1 UNDERGROUND TANK(MONITORINO/REMOVAL) ❑DOG KENNEL In DAIRY <br /> .�HArARDous WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ID PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATToOBODY PIERCING 0 POOL/SPA ❑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(2091464-0138 or mall 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 F-HD 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 /> `�r-- <br /> \ <br /> EHo 4402408 <br /> V141os <br /> ZOO Q!] QNVIXVO 1IUVK0H0 TVTI, C99 OTS XV3 90:VT ,LYS SO/6T/TT <br />