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03/02/2004 11: 11 9252836121 AEI CONSULTANTS .(SF) PAGE 01 <br /> END LOG NUMBER <br /> (p� <br /> Y E 0 <br /> SANT JOAQM COUNTY <br /> 2004 304 E Weber Ave 3'a floor Stockton., CA 95205 1 <br /> MAR 0 ax: 209 464-0138 Web: N-ww.co.san-joaq-Li,,.ca,us/ehd <br /> 1 <br /> (209)468-3420 F ( ) 111 <br /> ENVIRONMENT HEALTH <br /> rllfT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: (�►LL � —�l�l� /� gUSIfiESSIAGENCY: ! <br /> ADDRESS: r C (1�Q Y-1�>~ Q 'CJ .--IQ � <br /> PHDNE:_� FACSIMILE:,_ L��J��� �'' <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of application submittal) <br /> 1;�CHECKBOXTOEXPEDITEREQUES -$93.00 F —PEI <br /> UEST PROCESSED IN 3 BUSINESS DAYS <br /> Y c2TL&bATE <br /> SIGNATURE OF APPLICANT [)apartment Use Only AO <br /> UNIT <br /> FILE ADDRESS Rs NLy r <br /> Crtv <br /> 2 s� a �p`"f`Unit 2 <br /> y- Street <br /> 4. slr9et Unit 3 <br /> s, street <br /> Gt <br /> G <br /> s. suer GN Unit 4 <br /> 7. Street cur }:l�R — t� (�� <br /> e strna+ ❑ Unit 5 <br /> cm <br /> q S� <br /> arty <br /> 10, Street <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 13II USING ABATEMENT p SOLID WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 12 FOOD FACILITY 171 SOLID WASTE VEHICLE <br /> 'OTHER CLEANUP SITE(NON-LOP) ❑ DAIRY <br /> UNDERGROUND TANK(MONITORING/REMOVAL) [D DOC,KENNEFACILITY <br /> ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> §HAZARDOUS WASTE GENERATOR ❑ M KEEN AN In PUMPER TRUCKIYARDICHE.M TOILETS <br /> TIERED PERMITTED FACILrTY ❑ MOpUSPA ❑ LAND USE APPLJCA11ON SITES <br /> ❑ TATTOO/BODY PIERCING ❑ OTHER(PLEASE SPECIFY) <br /> ❑ MEDICAL WASTE FACILITY checkin <br /> 1• List up to ten addresses in the space above. Select tate type($)of files from the list above by 9 <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 208 A64-0138 or mail to the <br /> address indicated above. <br /> EHD will notify the applicant if any EHD files exist An appointment for review will bconfirmed <br /> 2application, The files <br /> approximately five business days but no later than ten (10) days after receipt of <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3, A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available, reorganized be by EHD staff at the expense <br /> 4 Any file not returned in the same condition as released applicant require a$93.D0 deposit prior to review. <br /> of the applicant Future file reviews by the same app- <br /> S, 'TENTATIVE appointment dates must be confirmed with EHD staff• <br /> g, applications received after 3:00 pm Will be processed the next business day. € <br /> I.I'�r 41.,.�'f.ME , IyI.I.�y::''� �l ,l.rll ::l•: <br /> O ENfi:DAT „ r.• a :,,,:':.I: ;;,:' r'.;':` <br /> N <br /> FIRM <br /> :4�l• l• <br /> l:71. <br /> , <br /> O� <br /> E <br /> ME <br /> y.•�� <br /> 1. <br /> D - <br /> - <br /> A <br /> TE <br /> Ef? •' 7. <br /> �n <br /> ;N <br /> em�e.osaoa <br /> SALa m <br />