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SEP. 8. 2005 2:39PM ERMNRAMENTO N0, 662 P. 1 <br /> ooEHD LOG NUMBER <br /> VED SAN JOAQUIN COUNTY <br /> SEP ENVIRONMENTAL�ALTR MPARTMENT <br /> P, 2005 304 East Weber Avenue, P Floor,Stockton,CA.95202-2708 <br /> ENVIROKII Telephone:(209)468-3420)Fax:(209)464-0138`Web:www.sj90v_0X91ehd <br /> PERMIT/SERVICES PUBLIC RECO"S RELEASE APPLICATION <br /> APPLICANT- es DUSINEMAWNCY. }UfYbFlivl l_ ._�t -S <br /> ADDRESS: Fl 47N[1 <br /> PHONE(S): tL 7 px 4 PHONE(2): t FACSIM[t E: <br /> TENTATIVE`APPOINTMENT DATE WA" d _ L1Q.8i k_. <br /> (Please allow 10 businoss days from date of application subMittal-'Tents W only-must be confirm F"r <br /> ;zr <br /> rl CHECK BOX To EKpimiT6 REQUEST-$9&00 FEE(GASH OR CHECK ONLY)-REQUEST PROCESSED INS BU5IN M DAYS <br /> SIGNATURE OF APPLICANT DATE 0V rx l_M1 <br /> VNITDMTWM MN ❑Unitf t3Unit Unit Unit4 g Unit6 0 Unl96 ❑ Other[electronl stWmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> +1w '. smot0 S4eetNama city <br /> tJ �a <br /> 4. <br /> 3. <br /> NA I <br /> 5. <br /> G. <br /> 7. <br /> 8. <br /> 8. . <br /> 10, <br /> Specific Data Range of InfOrtnation Requested:From � ���� - to --pow Ze A= <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DERGROUND TANK(UST)CLEluIUP sl rE{LOP} <br /> D Houstm AeATEMsr C 1 SouD WAsrm FACILITYWEHME <br /> I>� ERCLEANuP SITE(NDN.LOP) ❑FOOD FACUTT O WASTE TIRE <br /> an DERaROuHD TANK(sIIONCt'ORINGIR9dOVAL) 0 DOG KENNEL 0 DART <br /> O WAStErYa7fR TREATMENT PLANT <br /> WASTE GENEPATOR 0 CHICKEN RANG <br /> EKED P6RklTIED FACILITY O MOTELIHOTEL ❑PUMP9RT>3MMKJYAft=HEN TaLM <br /> G TAT FUOMODY PIERCING I7 POoVSPA 13 LAND Use APpuCA'nON$sTEs <br /> G MEDIr,AL WASTE FACIuTy ❑OTHER(PLEASE SPECIFY) <br /> YELL AND SEPTIC PEM L RECORDS ARE AVAILABLE FOR REMEW- MONDAY-FRIDAY 8:00 AM-5:0OPM - F)=1IDING HOUDAY& <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(@s). At least one file type MUST be selected. Fax to 209 464.0138 or mail to the address <br /> indleated above. Address ranges will not be accepted--for additional assistance with file addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files east An appointment for review will be confimted <br /> approxlmately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review, Anew 00 <br /> application may be submitted when the file is available. <br /> 4. Any file not mturned in the same condition as released will be reorganized by EHD staff at the expense of th <br /> applicant, Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> I <br /> END 4"Z406 <br /> IM4m6 <br />