Laserfiche WebLink
DATE RECEIVED EHD LOG NUMBER <br /> 411 SAN JOAQUIN COUNTY 10 <br /> ENVIRONMENTAL HEALTH DEPARTMENT qb AM& <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgoV.or <br /> i� PnAUBLIC RECORDS RELEASE APPLICATION \ r l <br /> APPLICANT: 1 t�VII�1��� i"!���� �� � t��S4�' BUSINESS/AGENCY: �� i 76 Jl <br /> ADDRESS: `(J36m AV k- CITY/STATE/ZIP ` � _ Pte.j CA i CI )Z /j <br /> PHONE(1PHONE(2)� Tt,Z —L �I FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ® CHECK BOX TO EXPEDITEEQUEBT-51055.0A0 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 1" -+ ` DATE '6_ I I Z �� <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 1. f� t S e M t U' d�'l�_4� 2 C E` S No o <br /> 2. CA , 336 <br /> 3. <br /> 4. I&, <br /> 5. <br /> Unit 4 <br /> 6. <br /> 7. <br /> ❑ Unit 5 <br /> 8. <br /> 9. <br /> ❑ Unit 6 <br /> 10. <br /> Specific''Date Range of Information Requested: From l i/ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 13 SOLID WASTE FACILITYNEHICLE <br /> ® THER CLEANUP SITE(NON-LOP) El FOOD FACILITY 13 WASTE TIRE <br /> ;�1 UNDERGROUND TANK(MONITORINGIREMOVAL)N E3 DOG KENNEL ❑ DAIRY <br /> CI HAZARDOUS WASTE GENERATORcA 13 CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> CI TIERED PERMITTED FACILITY 13 MOTEL/HOTEI, O PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑TATTOO/BODY PIERCING 13 POOL/SPA 13 LAND USE APPLICATION SITES <br /> El 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 appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail 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$105.00 deposit prior to review. <br /> EHD USE ONLY <br /> 'If you need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br /> EHD 48-06 8/04/2008 <br />