Laserfiche WebLink
b 2011`a\/x13: 16 831 356 FEDEX OFFICE 5138 PAGE 62 <br /> f4t -EIED <br /> BATE RECEIVED EHD LOG NUt,ABE <br /> "UL 2 7 2011 SAN .�OAQl1�IN COUNTYENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENTAL HEA 600 East Main St. StOCkton, CA 95202-3029 <br /> PERMIT/SERVICE <br /> HE phone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> G, <br /> APPLICANT: BUSINESS/AGENCY: EAS �yf/tc1F <br /> O �Jsvcxr��l, <br /> ADDRESS: I JD Si � /� <br /> _ CITY/STATEIZIP:1,.i4P1 7MA1 (,4 9ScJ J p <br /> PHONE(1): —1�/�—�Z 9 t? PHONE (2):C 'r 4R Q�(jf74lC.0FACSIMILE: <br /> TENTATIVF*APPOINTMENT DATE: - <br /> (Please allow 10 busineys days from date o'application submittal-"7entaf/ve onl Time: <br /> y-must be confirmed) <br /> ❑ CHECK BOX 1-0 EXPEDITE R�RUEST-: 12.2 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSEb IN 3 B SINES DAYS <br /> SIGNATURE OF APPLICANTS DATE 8 /j <br /> Electronic Information: ❑ List[J Map—Description: <br /> FILE ADDRESSEHp USE ONLY <br /> Street# I street Name city ' <br /> I _ <br /> 2, 21 <br /> 3. <br /> 4. <br /> Unit t <br /> —� ❑Unit 2 <br /> 5. Unita �my <br /> 6. <br /> 7. _ 1Unit4 <br /> 9. <br /> 10. _ <br /> - _._ ❑Unit 5 <br /> Specific Datb Range of Information Requested: From ❑Unit 6 <br /> ENVIRONMI=NTAL H[ALTH DFpARTMENT FILE. to <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT <br /> OTHER CLEANUP SITE(NON-LOP) D ❑SOLID WASTE FACILITYIVEHICLE <br /> NDERGROUND TANK(MONITORING/REMOVAL) 11DOG KENNEL ❑WASTE TIRE <br /> HAZARDOUS WASTE GENERATORDAIRY <br /> ❑ IERED PERMITTED FACILITY ❑CHICKEN RANCH DAIRY <br /> WASTEWATER TREATMENT PLANT <br /> El TATTOO/BOOY PIERCING d MOTFUHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑ MEDICAL WASTE FACILITY d PODIA SPA ❑LAND USE APPLICATION SITES <br /> EJ OTHFR WELL AND SEPTIC PERMIT RECORDS/4RE AVAILABLE OR REVIEW.- MONDAY-FRIDAY 5:00 AM-5:00pM(EXCLUDING <br /> 1. Lis u ( LUDING HOLIDAYS) <br /> o to add eases In the space above. Select the tYPE(s)of flies from the list above by Checkitfg the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209 45j&11;318 orai <br /> ranges will not be accepted for ado the address Indica d abov®. Address <br /> additional assistance iwlth file raddresses,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 nny 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 max;mum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked an 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 appPlcant may require a$1,22 deposit prior to revlew. <br /> EHD USE ONLY <br /> EEHOD48-De <br /> 87!29!70 ' <br />