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1 t 121 003 <br />{ <br /> 1`28/2004 13:24 FAX 209 948fi '1 } <br /> oA,TI.Rt cEIvEa SAN JOAQUIN COUNTY <br /> ENYIRONMNTAL HEALTH DEPARTM ENT <br /> 304 Tr.Weber Ave 3""Floor Stockton,CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:wWw40-i jaaqum-C2-Usfehd <br /> 40000,) Og <br /> PUBLIC RECORDS RELEASE ATPLICATIO <br /> "3 rC6APPUCANT: 1 _BUSINESSlAGENGY:, Y1]'Ke i <br /> LAI <br /> ADDRESS: ! <br /> II <br /> P140NE: <br /> 62 <br /> T>=NTATIIlE'APPOIMnYlENT QATE: 11 1 Time:.^ .E <br /> If <br /> (please allow ZO business days from-date of application submittal) <br /> ❑ <br /> Drm REQUEST-$93-09 FEE—REQUEST PROCESSED N3 BUSNESS DAY CHECK BOX TO!"JCPE j <br /> DATE 1 <br /> 51GlRATUIiE OF APPLICANT i j DepadmentUse Odd <br /> FILE ADDRESS uNlr_ t <br /> Unit'l <br /> z Unit Z <br /> ; ° f <br /> AA <br /> Cft <br /> s- sung Unit <br /> 7. - <br /> & <!n$5 <br /> 9. sued I� <br /> 10 seee II <br /> ENVIRONMENTAL HEALTH DEPARTMENT,FILES <br /> I S[t0 WASTE FACILITY <br /> ING ABATEMENT <br /> (� UNDERGROUND TANK N577 CM%jP SITE(LOP) ❑ FOUS <br /> ❑ FOOD FACILITY SoLin WASTE VEHICLE <br /> 19 OTHER CLEANUP SM(NON-LOP) ❑ DOG KENNEL � VAIRY <br /> 60 UNDERGROUND TANK(MONITOR1140MEklC)YAL) ❑ CHICKEN RANCH U pKG TPEATMENT PLANT E�TOILETS <br /> j4 HAZARDOUS WAS M GENERATOR ❑ CHICKMoMIN RAN 0 PUhtPFCR TRUCMAKDIGN <br /> ❑ TIERED PEWNITTI=D FACILITY C3 �/SPA i �L LAND USE APPLICATKIN$ <br /> ❑ TAITOOMODY PLERCING 17 OTHER(PLEASE SPECIFY) <br /> 0 MEDICAL W AZTF-FACK117y 11 checking <br /> e s of files from the list above oY <br /> ace above. Select the type{ ) iI to the <br /> 1. list up to ten addresses in the spare selected. Fax to 209 4G4-0438 or ma <br /> the appropriate box(es). At least one file type MUST be <br /> address Indic above_ appointment far review will be Confirmed <br /> D files exist. An appo g <br /> 2, EHD will notify the applicant if any EHer i <br /> approximately five busiriess days but no later than ten('l.�)days aftntmen ts should bschedul d files <br /> will be held.for a maximum of five business days for review. Appo <br /> accordingly. <br /> {e for review. Anew <br /> g. Afile that Is ac#iYely being worked on by EHD staff maty not be immediately availab <br /> application may be submitted when the file is available ' at the nse <br /> a. Any file not returned in the same condition as released wntlmabe`rer�u re a$93.00 Hd posit Staff Prior to rdview <br /> of the applicant. Future file reviews by the same appllca y q <br /> $, 'TENTATNE appointment dates mU tbll be cased dittie next business day.6, with EHE)SUff- <br /> Applications received after 3:00 p <br /> ill TIME `�' •ryvy''�'. `;�`_.:__ .J:r.°..�. <br /> CDN I,RTJt D` aiNTMF-rcrii lr <br /> E QNFlRM .PHONE i FAX . <<.. <br /> :bAT G El] ` <br /> REVIEWED YE5 <br /> Np RIMEW DATE- '1 v <br /> rim 4a-07-.aoc <br /> erarzoax .i, <br /> i' <br />