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88/26/2003 09: 56 209955688W GRUBB AND ELLIS PAGE 01 <br /> 4ATE RECEIVED EHD LOCI NUM! ; <br /> - SAN JOAQUIN COUNTY <br /> d 1 <br /> ` NVIRONMENTAL.HEALTH DEPARTMENT <br /> E <br /> 304 E Weber Ave 3`d Floor Stockton, CA 95205 <br /> AWG`266 468-3420 Fax: (209)464-0138 Web.wwwco.san-joaquin.ca.us/chd <br /> BENV RU T � �� PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ' ' Oram xoe BUSINESSIAQENCY: <br /> ADDRESS. 3 3 <br /> PHONE: !? �r ~ FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days Pram date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE..RE PROCESSED IN a BUSINESS DAYS <br /> SIGNATURE of APPLICANT DATE <br /> Doparpnnent Use Only <br /> FILE ADDRESS UNIT <br /> 1. $laaet 0 �lad / V ❑ Unit <br /> 2. 81Vaat G <br /> 3. traet a VUnit4 C Str" <br /> S. $ t �" <br /> 7. ci <br /> ®. Peal S ' city ❑ Unit 5 <br /> to- sveei <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> i�NDERGROU ND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> p,�UTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH M PKG TREATMENT PLANT <br /> ® TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILE' <br /> 0 TIERED PERMITTED <br /> BODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION BITES <br /> 0 ME oICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) -- <br /> 1. List up to ten addresses In the apace above. Select the typa(s) of files from the list above by chackl <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091464:2138 oralall tot4 <br /> addr2ss irldlco above= <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after <br /> rei tof application. <br /> The <br /> adfll <br /> will be hold for a maximum of five business days f9r review. App e <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for revlow. A i v <br /> application may be 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 ex,pe s <br /> of the applicant. Future file reviews by the game applicant may require a $93.00 deposit prior to rav V. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:40 pm Will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED RHONE FAX.' .-INITIALS <br /> REVIEW DATE <br /> REVIEWED YES NO <br /> �>+o u-0a-0va <br /> efanaa� <br />