Laserfiche WebLink
4.1.��r`'r `1� '�ll•ik,.r � '%fit;` .> .,- , � .i-.,•aa 5. �rf3zh �X,. �}�v .... c '-r ;•� r �'x��",' i <br /> ,...k,•:�y'�r.ry.y,w.e, 1�vY^�-=�` .. ,,.. �. _ ... ,... .,. .-n ,> v..; w,,ie't'fR.��1.��l+. �`�q'6,r y{.7 <br /> SAN JOAQU IN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> p,II 11 1 1 2005 344 East Weber Avenue,3Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web: www.sjgay.orglehd <br /> jq313 <br /> ENVIRONMENT HEALTH <br /> PERIA T/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: b't`t. j 4":p ih I SUSINiESSIAGENCY: AkGI- <br /> ADDRESS:= Z� rlw� i T'u.Aa01 4 <br /> PHONE(1): Z�� Ce�'�— CoI —PHONE(2): Zd�xC[ FACSIMILE <br /> TENTATIVE`APPOINTMENT DATE: 6 ZIP tJ--�a Time: Q'j 0-� <br /> (Please allow 10 business days from date of application submittal.*Tentative only-must be Confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST4`9t3.OD FEE(CASH OR CHICK ONLY)-REQUEST PROCESSED IN 3USINESS DAYS <br /> SIGNATURE OF APPLICANT ��.r--V--I� DATE Y)�l <br /> UNIT DISTRIBUT1oN 6 Unit 1 0 Unit 2 O Knit Unit 0 Unit 5 O Unit6 0 Other(electronkllistshnaps) <br /> FILE ADDRESS I EHD USE ONLY <br /> street 0 Street Name ; City <br /> 1. ?S t ZytA5 I S LK " <br /> 2. ti 5 E hNA" . z'k- ' c-� a <br /> {,ti4- l_4,�.-_ I t Ct <br /> 4. 22-itS E t n�e..,o a+- S-�_ ! S <br /> LI <br /> 5. iSCe3 5. �¢ s+.t at f2d. 1 EStalow3. <br /> 6. 44,04-4 �,Ic r, <br /> 7. co 1tAr ac <br /> e. a <br /> 110. ZJ YL e• Marc teA S G <br /> Specific Date Range of Information Requested:From Z. Q3 to <br /> i <br /> 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> )R V VDERGRol1ND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACIuTWOMICLE <br /> OTHERCLEANLIP SITE(NON-LOP) ❑Foot)6ctuTY 13 WAS TIRE <br /> ❑UNDERGROUNDTANx(MONITORINGIREMOYAL) 0 DOG KENNEL d DAIRY <br /> ^a�UEMOOkIC�YA><1'S i�CrE1M�R+OR '�1{,11f01�1iF'ti�NO!( DC7�YA¢b1ILMfR'reR i41LY1T111a1r�11llf <br /> 0 TIERED PF-RNIITteo FACILnY 0 MOTEL4I0TEL O PuMPERTRUCKIYARDICHEM TOILETS <br /> CI TATTOoMoDYPIERCING M POOLISPA Cl LA m USE APPUCATION SITES <br /> Q MEDICAL WASTE FACIUTY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAaIE FOR REVmEW- MONDAY-FRIDAYS:00 AM•6:00PM . EXCLUDING HOUDAYS. <br /> 9. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHD.Applications received after 3:00 prn will b'e processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist An appointment for review wilt be confirmed <br /> approximately ten{10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD stalmay not be immediately available for review. Anew <br /> application may be 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EHD 49.OZ•006 <br /> 111U05 <br /> I <br />