Laserfiche WebLink
DATE RECEIVED <br /> SAN JOAQUIN COUNTY END LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web. www.sjq M14 <br /> 0 <br /> �PUBLIC RECORDS RELEASE APPLICATION r <br /> APPLICANT: RICH4R0 N Lfl o BUSINESS/AGENCY: GN U'1;U <br /> ADDRESS: SBO W,IIM' A Clty/$tate/ZipI' 00- p10("4 <br /> PHONE(1): 'Z_ G4' 6�� Q- 6 PHONE(2): Z04 2( 'Z 6 6 S —FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: (Z-3v-O Time: A D <br /> (Please allow 10 buslnass days from data a plicatlon submittal-"Tantative only-must be confirmed) <br /> 0 CHECK BOX TO EXPEDITE REQU $105 F C HO ECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ L)st❑Map 4 Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> Unit 1 <br /> ) C , D <br /> 2. L v 4k SOC S . !A'VE? © Unit <br /> 3. <br /> 4' 3 ,Z O Unit s <br /> 6. I r c�\ <br /> 6. +��l.I �g Unit 4 <br /> 7. Jl'I, ,t <br /> a- 33_� 14 `4 �sa ❑ unit 5 <br /> 9. L uS s vt�' ❑ Unit-6- <br /> 10, Z 3 p 6a.S4re& AIS <br /> Specific Date Range of Information requested:From aveb:0 to pros en, <br /> ��// ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> A UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOU$ING ABATEMENY 0 SOLID WASTE FACILITY/VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑WA5TE TIRE <br /> V UNDERGROUND TANK(MONITORANoIREMOVAL) Cl Doo KENNEL 0 UA,RY <br /> �V,FIAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITYEo FACILITY 0 MOTEUHOYEL 0 PUMPER TRUCKIYARD1CHEM TOILETS <br /> L'7 TATTOOIBODY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> D MEDICAL WASTE FACILITY 0 OTHER(PLL:A5E SPE,CiFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILA ILE FOR REVIEW -MONDAY-FRIDAY 8:00 Aw5:0OPM - EXCLUDING HOLIDAYS. <br /> 1. List up to tan 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 mall 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 /> END USE ONLY <br /> EHD 48-08 8104/08 PUBLIC RECORDS RELEASE APP FORM <br /> TO 39Vcl N0dId039N3 96LT66960Z TV:TT 8002/LT/ZT <br />