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06/22/2004 11:59 303769 <br /> .�� TECHLAW INC PAGE 02/0 <br /> DAT SEEiVS3 EHD LOG NLIMBLR <br /> I� ��' _ SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUN 2 2 2004 304 E Weber Ave 3`d Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web: www.co.san joaquin.ca_us/chd <br /> ENViRD Wal Ei1 k' hbLl h <br /> PER��Jil fISERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: _ kI`k �t„oc�iY' 8U91NES3JAGENGY: G <br /> _ f' h L[ V1/ <br /> U <br /> ADDRESS: 1 �y <br /> PHONE: FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 twsiness days from date of appileatlen submittal) <br /> 0 CHECK BOR TO EXPEDITE REQUEST-$93.”FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT A l P� Llf` DATE _ Z <br /> Department Use Only <br /> r� FILE ADDR1=5$ �-'•�`� ,•-. ^� 1iK17 <br /> 1jJt'(�rU Ulc� 4, s4reet vCRYf <br /> Cl Unit 4 <br /> Z f G5 <br /> 3. SV994 5T • 15 ir `l 1. CAY "3L/ <br /> Unit z <br /> 4. stme 0 C. + ' <br /> 5 Svae; �ld cc�. L'YY G <br /> ILJnlS, C 7. s4r�es 3 cn ✓ 4 <br /> to. sveec v r <br /> V <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 11 <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACIL>TY30' <br /> OTHER CLFANUP SITE(NON-LOP) 4 FOOD FACILrry M SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGMEMOVAL) ❑ DOG KENNEL [7 DAIRY <br /> HAZARDDUS WASTE GENERATOR d CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑ MOTELfHOTEL © PUMPER TRIJCKNARDICHEM T'oILETS <br /> ❑ TATTOOMODY PIERCING 0 POOLISPA ❑ LAND USE APPLICATION SITES <br /> Q MEOICAL WASTE FACILITY ❑ OTHER(PLEASE SPED M <br /> 1. List up to ten addresses in the space 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 (20914$4.0138 or mail to the <br /> address indlcated 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 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 he 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 some applicant may require a$93.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> S. 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 /> +icy"42-099 <br /> arnixoffs <br />