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--FTug 12 03 05: 08, Matt Milnes <br /> 09/15/2003 11:32 46401 ENJIRONMENiHEAL <br /> AL HEAL-9250 1 <br /> \ <br /> J DATE iECE1VE0 �. PAGE 01 <br /> env wv••vn•.� ! <br /> SAN JOAQUIN COUNTY <br /> L ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3d Floor Stockton,CA 95205 <br /> SEP 1 5 2003 (209)468-3420 Fax: (209)464-0138 Web:www.co.sanjoaquin.ca.us/ehd I o <br /> LLNVIRONMEN I HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> PER pp <br /> APPUCANT: 'IN BUSINESSIAOFJICY: ��pen �Ai <br /> ADDRESS: 1'710 - w /G y <br /> PHONE: _209 -61y- 019 2_ FACS ILE: z'9 - YTw-�iati <br /> TENTATIVE'APPOINTMENT DATE: Tyne: <br /> (Ploase allow 10 buslnna days from date of sppliratlon submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-Ss3.00 E - OUEST PROCESSED IN 3 BUSINESS DAYS ZAJU3 <br /> SIGNATURE OF APPLICANT DATE C '— <br /> Deosrtment Use Only <br /> FILE ADDRESS UNIT <br /> r 1 Unit I <br /> x i o <br /> x. seenCik V <br /> 1, <br /> K. s. Unit 2 <br /> cSEP 17 2003 <br /> a. a•.«. nil �\n <br /> SYM e <br /> Unit 4 <br /> e. Wer Gi <br /> City <br /> O Steen O <br /> ❑ tenet 5 <br /> 10 Snwl <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Z'UNDERGRDUNO TANK(USTI CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FAC <br /> BOTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> pJ UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL 0 DAIRY <br /> fd HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL JW PUMPER TRIICKIYAROICHEM TOILETS <br /> ❑ TATTOOMOOY PIERCING ❑ POOUSPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY _W OTHER(PLEASE SPECIFY) vim.f 5 tv't 1r IMidi <br /> 1. List up to tan 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(209)464.0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant It 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 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 wig 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 /> S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3;110 pm will be processed tho next business day. dLft LJ <br /> CONFIRMED APPOINTMENT DATE TIME x <br /> DATE CONFIRMED PHONE . FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> E DYyy-0N <br /> MnAAI <br />