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F <br /> ,fab 05 04 01 : 18p Sic :"7'�IBLIC WORKS ;�4G9 296` P. 1 ` <br /> EHD LOG NUMBER <br /> ! DATE RECEIVED _r <br /> �� f�� �l l�, I'I !,i SAN JOAQUIN COUNTY <br /> �' - ENVIRO. MENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`d Floor Stockton, CA 952051 <br /> } MAY 0 5 � }468-3420 Fax: (209)464-0138 Web, w,,vw.co.san-JI8'aquin.ca.us/chd 02 <br /> 1� <br /> ENVIRONiVll ql ' 'tALIH 'PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Claudia Gemberling BUSINESSIAGENCY. San Joaquin County Public Warks Department <br /> ,3 <br /> ADDRESS: 1810 E. Hazelton Avenue, Stockton, California 95205 <br /> PHONE: 953-7624 FACSIMILE: 468-2999 <br /> TENTATIVE*APPOINTMENT DATE: II, Time: <br /> (Please allow 10 business days from date at appiicatlan�suhmittal} .y <br /> CHECK BOR TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINI ESS DAYS <br /> SIGNATURE OF APPLICANT I DATE 5-6-o <br /> Department Use Only <br /> FILE ADDRESS V Ij UNIT <br /> ❑ Unit 1 - <br /> 2. sweet 6 c0 5. `r -H CRY /j,��� <br /> 3. St e, a '� :` unit 2 r^f J <br /> .. swt s, er{. <br /> ee 'f ; <br /> s. sweet cad!00 S. `r tw+Wu u Unit 3 <br /> e. sweat <br /> S. Unit 4 <br /> r. song . <br /> ii <br /> a. Saes <br /> 9. 6lreal �� nit 5 <br /> If <br /> 10. SLoet <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) d HOUSING ABATEMENT �I �i[SOLID WASTE FAciLrIY <br /> OTHER CLEANUP SITE(NON-.AP) a FOOD FACILITY i C] 50Lfd WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL i -DAIRY <br /> HAZARDOUS WASTE GENERATOR _ <br /> CHICKEN RANCH � 0 PKG TREATtAENT PLANT <br /> TIERED PERMITTED FACIifrY MOTEL1HOTEL I' C7 PU{HPER TRUCKIYARD/CHEM TOILETS <br /> TATTOOlBODY PIERCING 0 POOLlSPA ! 0 LANA USE APPLICATION SITES <br /> Cl MEDICALWASTEFACILrY 0 OTHER(PLEASE SPECIFY) <br /> y <br /> i. List up to ten addresses in the space above. Select the types) f files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected: Fax to 209 464-0138 or mail to the <br /> address Indicated above. I� <br /> 2. EHO will notify the applicant if any EHD files exist. An appointmnt for review will be confirmed <br /> e <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <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. }} I <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> applicant ma require a$93.00 deposit prior to review. <br /> of the applicant nt. Future file reviews by the same pp Y , ) <br />� PP � <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> bNFIRIVIED APP011l1`N�I=�11 <br /> T----- <br /> -bATE CONP4.P1MED" <br /> � 1Nl <br /> �t <br /> F <br />