Laserfiche WebLink
03/30/2010 09:19 2093338303 LODI DOWNSTAIRS PAGE 02/02 <br /> EHD LOG NUMBER <br /> MD ( D SAN JOAQUIN COUNTY <br /> 111 ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAR120 i0 600 East Main Street, Stockton, C0.95202-3029 <br /> Telephone; 209) 468-3420 Fax; (209)464-0138 Web: wvvnrr.sjgov.org/e d <br /> ENV IRUIV10':cdT HEALTH <br /> PERf�fT'SERViCES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: —Ti nn BUSINESSIAGENCY: <br /> ADDRESS: _90ZIndustriaWhy - <br /> Cityrstatelzip L_tCA9524 <br /> PHONE(1): �OqT 3fi370�� PHONE(2): FACSIMILE: 2Q2-3M_-4228_ <br /> 03-31-10 Time: gam <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> M 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 /> Electronic Information: ❑ List❑ Map-Description: <br /> FEHD USE ONLY <br /> FILE ADDRESS <br /> Street# Street Name City ❑ Unit i <br /> W. Turner Road _ Lodi N ` 3` <br /> V J2. 110 Turner Road -- - Lodi �?���G� � unitz <br /> 3. - -- --. --- — Unita <br /> 4. <br /> 5. Unit 4 <br /> 6. <br /> 7 5 <br /> ^ J ❑ Unit <br /> g ❑ Unit s <br /> 10. . <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FFLES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING AUATEMENT 0 SOLID WASTE FACILITYNFHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑INASTE TIRE <br /> XUNDERGROUND TANK(MONITORINGlREMOVAL) V'k 0 DOG KENNEL 0 DAIRY <br /> Q WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR CI CHICKEN RANCH <br /> TIERED PERMITTED FACILITY 13 MOTEL/HOTEL ❑PUMPER TRUCKIYARD/CHEM TOILETS <br /> *TATToO/Botw PIERCING Gl POOLISPA ❑ LAND USE APPLICATION SITES <br /> *MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) „ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 Ahi-5:OOPM - 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(es). At least one file type MUST be selected. Fax to(2091464�Ot38 or mdll to the address indicated aboy'e.- 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 tan(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 flto that is actively being worked on by EHD staff may not be immediately available for review. A new application may he <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 expanse of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> EHD USE ONLY <br /> 1 �Gt. U 7" ,, <br /> 0 <br /> EHD 48-06 81 4 PUBLIC RECORDS RELEASE APP FORM <br />