Laserfiche WebLink
EHD LOG NUMBER DATE RECEIVED <br />fe) 6(1 IP <br />7/5‘54F1(1 <br />10/AAt <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />one: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orgiehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: z-se,)// kfcx, BUSINESS/AGENCY: /1-77 2/9214/ 721,4:9.2047:Z7:-. <br />ADDRESS: 111-1520 A2,991. 6.-,127 6-A Vt5 ' c) "5: CITY/STATE/ZIP:..c/901)/9.17)-P2/ZI 9941/ <br />PHONE (1): '// 5 4 20.0 PHONE (2): MS 21( 5 POW FACSIMILE: /6 5Pz 2 2 2 <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only must be confirmed) <br />0 CHECK BOX TO EXPEDITE REQUEST- $125 FEE (9AISH,9R CHECK ONLY) - REQUEST PROCESSED INS BUSINESS AYS <br />SIGNATURE OF APPLICANT DATE cilh-3/1/3 <br />- <br />I Electronic Information: List I I Map - Description: • <br />FILE ADDRESS END USE ONLY <br />Street # Street Name City 11 Unit 1 <br />1 • :3i W 048-0,41 hinil 5"1:d2ch/7"a4/ <br />cioceroA/ a 3975- /V, 144/-sov wiP7 Unit 2 <br />3' 909 1 Af, ktiii-S'a,"„/ WA2 Y cr ereml, <br />4. 1:14 " frvi 1. safil W/9-Y Yrock *V; <br />P-aci,(7-V/S- <br />77 eff MAY - ..6 , <br />Unit 3 <br /> 400": /lit Wur_50*IN-19-y <br />- <br />g I> 14.4.S <br />-; 2 iic., (tyre truls404)-ii t 4 '4,06:r 41, A/ I 1.-S a it/ M il ki i <br /> 4L7()N <br />9/615-- <br />, Wa-5 al kt-/XY <br />Alf kill --5: e7A1 i'MY <br />570C)e7ail <br />,,)76csit° ar / <br />-'z i.'' <br />°"') *5113 7.9561 • Unit 5 Af, wi am,/ Wiivi i sret:Ogieev r,- • <br />10. Unit 6 <br />Specific Date Range of Information Requested: From <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />to <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON-LOP) <br />UNDERGROUND TANK (MONITORING/REMOVAL) <br />HAZARDOUS WASTE GENERATOR <br />_TIERED PERMITTED FACILITY <br />LI TATTOO/BODY PIERCING <br />LI MEDICAL WASTE FACILITY <br />0 HOUSING ABATEMENT <br />0 FOOD FACILITY 0 DOG KENNEL <br />0 CHICKEN RANCH <br />LII MOTEL/HOTEL <br />0 POOL/SPA <br />0 COMPLAINT RECORDS <br />SOLID WASTE FACILITY/VEHICLE 0 WASTE TIRE 0 DAIRY 0 WASTEWATER TREATMENT PLANT D PUMPER TRUCKIYARDICHEMICAL TOILETS <br />0 LAND USE APPLICATION SITES 0 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:00pm (EXCLUDING HOLIDAYS) <br />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 />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 fora maximum of five business days for review. Appointments <br />_ _should be scheduled ac_cor_dingly <br />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 />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 $125 deposit prior to review. <br />END USE ONLY <br />EHD 48-06