Laserfiche WebLink
09/29/2006 MON 16126 PAX 209433 SJC EBD 0 0002/002 <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOO 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.sjgov.or /ehd <br /> PUBLIC RECORDS RELEASE APPLICAT N <br /> APPLICANT: orvtAS y BUSINESSIAGENCY: a <br /> ADDRESS: 35' cGfSS OM <br /> PHONE(:): Z09 597- Z,604 PHONE(2): 3/Z. 89'2. d�/3 FACS O 3 /`-9c7 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow ten business days from date of application submittal-"Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 76010 8 <br /> Electronic Information: [�-Cist[]Map-Description: MndkAPjvI4 AW— 6,wlz, <br /> _ FILE ADDRESS _ _ EHD USE ONLY <br /> Streetk Street Name City 11 Unit <br /> Unit 2 <br /> 3. <br /> 6. ---------- -- —-- <br /> -- ----- ---- '---'----- <br /> 6. ❑Unit 4 <br /> 7. <br /> 8. <br /> -- -- --- 0Unit 6 <br /> TI?O --- <br /> ❑Unite <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> O UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT 0 SOLID WASTE FACILITYfVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) OFOOD FACILITY 0WASTE TIRE <br /> I7 UNDERGROUND TANK(MONITORINGfREMOVAL) l7 DOG KENNEL M DAIRY <br /> C7 HA]ARDOUS WASTE GENERATOR ❑CHICKEN RANCH M WASTEWATER TREATMENT PLANT <br /> O TIERED PERMMED FACILITY ❑MOTEUMOTEL M PUMPER TRUCKIYARDICHEM TOILETS <br /> C3 TATTOWBODY PIERCING 0 PPOLJSPAC3 LAND USE APPLICATIONSITES 1 <br /> I7 MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) �'1 aK <br /> j L� (tC L. ggtl J)", <br /> WELL AND SEPTIC PERART RECORDS ARE AVAILABLE FOR REMEW-MONDAY-FRIDAY A=AM-6:DGPM-ExCLUDiNG HOLIDAYS. /V�nCry <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 mall to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> 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 <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 nle that is actively being worked on by the EHD staff may not be immediately available for review. A new application <br /> may be submitted when the 81e 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 some applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 48-0 1M%07 P 9LI0 RECORDS RELEASE WP FOR* <br />