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FROM : Ground Zero RnaTi. is PHONE NO. : 209 838 9883 Nov. 29 2005 10:19AM P1 EHD LOG NUMBER MIMEMIME SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT N O V 2 9 2005 304 E Weber Ave 3`d Floor Stockton, CA 95205 (209) 468-3420 Fax: (209) 464-0138 Web: www.co.san joaquin.ca us/ehd ENVIRONMENT HEALTH PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: ADDRESS: BUSINESSIAGENCY: TENTATIVE' APPOINTMENT Time: V (Please allow 10 business days from date of application submittal) © CHECK BOX TO EXPEDITE REQUEST -$93.0n0 FrEE.—REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT DATE Department Usa Only ENVIRONMENTAL HEALTH DEPARTMENT FILES r ❑ Unit t Q Unit 2 /Unit Unit 3 4 ❑ Unit 5 :NDERGROUND TANK (OST) CLEANUP SITE (LOP) El HOUSING ABATEMENT ❑ SOLID WASTE FACILITY Y�THER CLEANUP SRE (NON -LOP) O FOOD FACILITY El SOLID WASTE VEHICLE W UNDERGROUND TANK(MONRORINGIREMOVAL) 0 DOG KENNEL O DAIRY iq' HAZARDOUS WASTE GENERATOR 17 CHICKEN RANCH 13 PKGTREATMENT PLANT ❑ TIERED PERMITTED FACILITY 0 MOTELIHOTEL n PUMPER TRUCKreARDICHEM TOILETS O TATTOOBODY PIERCING 4 OUSPA Cl LAND USE AP?U�C�TIONOins A yIEDiCALWASTE FACWTY J�OYNER (PLEASE SPECIFY)719�`I—iz—.i/ 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 40"138 or mail to the address indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of Five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $43.00 deposit prior to review. 5. 'TENTATIVE appointment dates must be confirmed with EHD staff, 6. Applications received after 3:00 pm will be processed the next business day. CONFIRMED APPOINTMENT DATE TIME DATE CONFIRMED PHONE FAX INITIALS REVIEWED YES NO REVIEW DATE _ smam xuoe rmizoo� FILE ADDRESS z swa ey s atr a cky .. sscet c s. ew.t s. sweet r. sneer a a 3 C 9. Street � 0. 3eN ENVIRONMENTAL HEALTH DEPARTMENT FILES r ❑ Unit t Q Unit 2 /Unit Unit 3 4 ❑ Unit 5 :NDERGROUND TANK (OST) CLEANUP SITE (LOP) El HOUSING ABATEMENT ❑ SOLID WASTE FACILITY Y�THER CLEANUP SRE (NON -LOP) O FOOD FACILITY El SOLID WASTE VEHICLE W UNDERGROUND TANK(MONRORINGIREMOVAL) 0 DOG KENNEL O DAIRY iq' HAZARDOUS WASTE GENERATOR 17 CHICKEN RANCH 13 PKGTREATMENT PLANT ❑ TIERED PERMITTED FACILITY 0 MOTELIHOTEL n PUMPER TRUCKreARDICHEM TOILETS O TATTOOBODY PIERCING 4 OUSPA Cl LAND USE AP?U�C�TIONOins A yIEDiCALWASTE FACWTY J�OYNER (PLEASE SPECIFY)719�`I—iz—.i/ 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 40"138 or mail to the address indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of Five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $43.00 deposit prior to review. 5. 'TENTATIVE appointment dates must be confirmed with EHD staff, 6. Applications received after 3:00 pm will be processed the next business day. CONFIRMED APPOINTMENT DATE TIME DATE CONFIRMED PHONE FAX INITIALS REVIEWED YES NO REVIEW DATE _ smam xuoe rmizoo�