Laserfiche WebLink
■ <br />0� DATE RECEIVED <br />T-1 <br />q <br />RECD DEC <br />APPLICANT: <br />ADDRESS: <br />PHONE (1): <br />SAN JOAQUIN COUNTY <br />EHD LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT 7qqSl <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />:: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/elid <br />RECORDS RELEASE APPLICATION <br />PHONE (2):: <br />BUSINESS/AGENCY:I/L116aLQc�I 6�, %�i�bGCCc bre <br />CITY/STATE/ZIP: (Ct S2-0� <br />FACSIMILE: (70v,) 4co P —a9Ti <br />i <br />Please allow 10 business days from date of application submittal for the records t0 be available. <br />Staff will contact you to arrange an appointment date and time to review the requested records. <br />❑ CHECK BOX 1'0 EXPEp TERE - $130 (CA H O HECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICA T DATE <br />Eiectronlc Information:- <br />Int ❑ - Dtscript n: <br />to <br />Street# <br />JILE <br />ADDRESS <br />Street Name City <br />EHD LISE ONLY <br />[Unit 1 <br />SOLID WASTE FACILITYNEHICLE <br />OTHER CLEANUP SITE (NON=LOP) <br />S . <br />Wotto G <br />G(- ow 120 7 6 Ii/tt. <br />/� <br />. r�® epj / 1'f <br />zl�iUnit 2 <br />2' <br />2 7 <br />FOOD FACILITY <br />DAIRY U17 j 3, /- I Z —IS <br />CO <br />bLLDaJ r2-0 Tv' � <br />�� <br />Unita <br />WASTEWATER TREATMENTPLANT <br />qq5g D�. <br />5- <br />ti�f�1�! <br />CO <br />S L <br />(- t_.I�&W , i <br />ePS t2_0 <br />q6 �� z-25 oZ <br />O Lain 0 P fz-- <br />Ef unit4 <br />S. <br />a(,,0 <br />7. <br />o <br />-Scjq C <br />Irc 12®N. <br />"'41 _ <br />v unit 5 <br />9. <br />Unit 6 <br />10. <br />Specific Date Range of Information <br />equested: From <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEAN U <br />SITE (LOP) <br />❑ MEDICAL WASTE FACILITY <br />SOLID WASTE FACILITYNEHICLE <br />OTHER CLEANUP SITE (NON=LOP) <br />19 HOUSING AOATEMENT <br />� <br />WASTE TIRE Y {-� �PS, i CD /i// <br />UNDERGROUND TANK (MONITORING/ <br />EMOVALb�— <br />FOOD FACILITY <br />DAIRY U17 j 3, /- I Z —IS <br />A60vEGPOUNDTANK <br />ECHICKEN <br />RANCH/DOG KENNEL <br />WASTEWATER TREATMENTPLANT <br />HAzARDouS WASTEIHAZARDOUS MATERIALS <br />0 <br />® MOTEL/HOTEL <br />rA PUMPER TRUCKIYARDICHEMICAL TOILETS <br />TIERED PERMITTED FACILITY L-,(, <br />® POOL/SPA <br />LAND USE APPLICATION SITES <br />❑ TATTOO/BODY PIERCING <br />l�dl COMPLAINTIRESPONSE RECORDS <br />OTHER (PLEASE aSPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS <br />ARE AVAILABLE <br />FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses in th <br />box(es). At least one file type <br />ranges will not be accepted. l <br />2. F'or assistance in identifying <br />3. The EHD will notify the applic <br />days after recelpt of applicati <br />should be scheduled accordli <br />space above. select the type(s) of files from the list above by checking the appropriate <br />MUST be selected. Fax to (209) 454-0138 or mail to the address indicated?hove__- Address <br />pplications received after 3:00 pm will be processed the next business day. <br />he nature and content of EHD records, please contact EHD at the number noted above. <br />int if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br />n. The files will be held for a maximurn of five business days for review. Appointments <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 $130 deposit prior to review. ' BQXED AREA - EHD USE 4Nl Y " <br />■ Records <br />EHD 4S-06 09101/14 <br />Received Time Dec. 18. 2014 3:30 No.7748 <br />