Laserfiche WebLink
4 <br /> �E WiV <br /> E Do <br /> JAN JOA QUIN L' EHD LOG NUMBER <br /> OUNTY <br /> AUG 14 2009 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> ENVIRCNNIEN T HENWhone: (209)468-3420 Fax: (209)464-0138 Web:www,sjgov.org/eh <br /> 07 0 <br /> PERA,111iT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ato_,,,.k ekz,,5 BUSINESS/AGENCY: �J L <br /> ADDRESS: ���� ��� elm,.,., Ave-e c— CITY/STATE/ZIP: Sy-o - ¢p ti <br /> PHONE(1): ��� —y6��.��gS�PHONE(2): FACSIMILE: 7_03 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT '�� DATE e110 <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city Unif 1 <br /> 2. 7� �0.T� GL r- �v4 Ct S�ik(o Unit <br /> 3• <br /> I 4. Z <br /> eV%l, � Unita <br /> e_-t-I r <br /> r6. 2 3 50.rvfc�_ L,l -o ,c'C <br /> �Znit 4 d A <br /> 7 <br /> .� � �Q. 1 •K•CNS/I. .ro :f' <br /> O <br /> Unit 5 <br /> 9. Z Ar w rac,` �s n <br /> 10. er q.' V e p%.0 r✓ �SC a �m v� ❑Unit 6 <br /> Specific Date Ran�6 of Information Requested: From to <br /> I� ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,UNDERGROUND TANK(UST)tLEANUP SITE(LOP) OUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> t ,OTHER CLEANUP SITE(NON-LOP) QOD FACILITY ❑WASTE TIRE <br /> KPNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑DAIRY <br /> I HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> 1 ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SfTES <br /> ❑ MEDICALWASTEFACILITY <br /> ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. 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 /> 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$115.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***If you need further assistance please contact Diane Martinez @ (209)468-34,25 directly. Than You.94 <br /> i <br /> I <br /> I <br /> EHD 4M6 <br /> 7131Y1009 <br />