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03/25/2004 17:49 41598999'd - ENVSF PAGE 01 <br /> SAN JOAQUTN COUNTY <br /> MAR 2 6 2004 ENVIRONMENTAL HEALTH DEPARTMENT 17q"7 <br /> 304 E Weber Ave 3"Floor Stockton, CA 95205 <br /> ENVIRONMENT H400b '468-3420 Fax: (209)464-0138 Web: wWw.co.5an-joaquin.ca.us/ebd <br /> PERMITiSERVICES <br /> PUBLIC RECORDS RELEASE <br /> �• A�YPLICATION <br /> APPLICANT: BUSINES-51)1GENGY: "I� 4Ve <br /> p-CA <br /> ADDRESS:— 284 -roCW-A 7 ✓ly , �e &t 'f�(7CO <br /> PHONE: FACSIMILE: q- qq-3zl <br /> TENTATIVE'APFUINIMENI VAIs: f Time: <br /> (Please allow 10 business days from date of application subminali I R <br /> CHECK BOX TO EXPEDITE REQUEST.$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � GP/_ e'/(it 1YfZJ' DATE <br /> �i eparlment use Only <br /> ua a FILE ADDRESS UNIT <br /> t.' Sm /O 66nora tpf W-0'57f- D ❑ Una 1 <br /> .,a o f �, e <br /> il <br /> El Unit 2 <br /> N 4 L19SSi�& fC �w1 P ft V C !` <br /> ON <br /> 6. etrvetC 11 n 1 1 t(A., <br /> /. "bveRt y( 7LArnpi0 I l Una 4 <br /> B,U'��SrrrnGr ( o ✓- C <br /> VFW <br /> ❑ Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ID"UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT - ❑ SOLID WASTE FACILITY <br /> O OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY O SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) LI DOG KENNEL 13 DAIRY 4V <br /> 13 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH M PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY O MOTELIHOTEL O PUMPER TRUCKIYARDICHEM TOILETS <br /> O TATTOOtBODV PIERCING O POOLICPA ❑ LAND USE APPLICATION SI E9 <br /> MEDICAL WASTE FACILITY n OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the Apace above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant If any EHD files oxist. An appointment for review will he confirmed <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. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EMD 4542-so6 <br /> ea/mss <br />