Laserfiche WebLink
P. <br /> RECEIVED SAN JOA UI COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> ENVIRONMENTAL HEAL%Iephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> PERMIT/SERVICES <br /> APPLICANT: PUBLIC RECORDS RELEASE APPLICATION <br /> W'✓i C-C /C t'- BUSINESS/AGENCY:_AL/A�/ '3_ <br /> ADDRESS: Y�5S- <br /> PHONE (1): JL(,.,_ - <br /> 717 -Z <br /> PHONE(2): FACSIMILE:�i;1_ Vjl ,, <br /> TENTATIVE*APPOINTMENT DATE: 3 -12 -11 Time: Z I <br /> (Please allow 10 business days from date of application submittal-'Tentative oniy_must be confirmed) <br /> ❑CHECK BOX TO EXPEDITEPROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE .j <br /> Electronic Information: List Ej Map—Description: <br /> ------ FILE ADDRESS EHD USE ONLY <br /> Street# T Street Name City <br /> _ _ - - r ,�.? _ — El Unit 1 <br /> . <br /> 3. [I unit 2 <br /> 4. <br /> -<Onit 3 <br /> 7. nit 4 <br /> 8, <br /> Q Unit 5 <br /> El Unit 6 <br /> Specific Date Range';'.7.r—..tion Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) R HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 7 FOOD FACILITY WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORING/REMOVAL) Q DOG KENNEL El DAIRY <br /> HAZARDOUS WASTE GENERATOI(\/' E:1 CHICKEN RANCH❑ F�WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY MOTELIHOTEL E]PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING POOLJSPA D LAND USE APPLICATION SITES <br /> EIMEDICAL 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 /> I. 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)4640138 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$122 deposit prior to review. <br /> EHp USE ONLY <br /> EHO 46-00 <br /> 07/29110 <br />