Laserfiche WebLink
03/30/2010 09:19 2093338303 LODI DOWNSTAIRS PAGE 02/02 <br />EHb LOG NUM9ER <br />HOMED SAN JOAQ!UIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />MAR2p�p 600 East Main Street, Stockton, CA 95202-30:x.9 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: v1wN.sjgov.org/e <br />ENvIRUNN)ENT HEALTH _ <br />PER iT' ERViCES P L,AC RECORDS RELEASE APPLICATION <br />APPLICANT: Ti BUSINESSIAGENCY. l� <br />ADDRESS: �_. nd strl W _ CitylStatelzip L t, CA95��,40 <br />�(��y FACSIMILE; .2.0230-4 .M— <br />PHONE (1): L(L9.3 7 70j_ PHONE (2): -- _. <br />TENTATIVE* APPOINTMENT DATE: 03-31 -10 <br />Time: gam <br />(please allow 10 business days from date of application submittal - "Tentative only - must be confirmed) <br />d CHECK BOX TO EXPEDITE REQUEST - $105 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT ,— DATE 4-12-10 <br />F:I. trnnir- Information: n List ❑ Map — Description; <br />Specific Date Range of Information Requested: From <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />to <br />UNDERGROUNo TANK (UST) CLEANUP SITE (LOP) 0 HOUSING AUAYEMENT 0 SOLID WASTE FACILITYlVEHICLE r-4:' <br />.'OTHER CLEANUP SITE (Nowt -OP) 0 FOOD FACILITY ❑WASTE TIRE <br />.UNDERGROUND TANK (MONITORING/REMOVAL) !%C3 DOG KENNEL 0 DAIRY <br />(HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH C7 WASTEWATER TREATMENT PLANT <br />® TIERED PERMITTED FACILITY 0 MOTEI-IHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br />• TATTOOIBODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION SITE$ <br />0 MEDICAL WASTE FACILITY 0 OTHER (PLEASE SPECIFY)_ _.® <br />WELL AND SEPTIC PERMIT RECORDS ARE AvAILADLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM -5:00P <br />M -EXCLUDING HOLIDAYS. <br />1. List up to ton addresses In the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(®s). At least one file type MUST be selected. Fax to (209) 464 0 t38 or mall tc the address indicated above, Address <br />ranges will not be accepted -- for additional assistance with file addresses, contact the EHq. 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 trap (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 deposit prior to review. <br />EHD USE ONLY <br />