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11/07/2003 16:12 9168610430 SECOR PAGE 01/0 <br />EHD LUId NUMHCK <br />DATE RECEIVED • SAN JOAQUIN COUNTY <br />L ENVIRONMENTAL HEALTH DEPARTMENT <br />ici)/, i�' �' ° /�� (���, ((1 304 E Weber Ave 3rd Floor Stockton, CA 95205 �/ <br />l �`'('-°�`468�I o Fax: (209) 464-0138 Web: WWw.cO.san joaquin.ca us/ehd 5q <br />NOV 0 7 2003 PUBLIC RECORDS RELEASE APPLICA'JON <br />I <br />FINVIRUNt T 1 BUSINESSIAGENCY: Sfra1L 147Eas1.t Lmlo ttCg��`ur�n <br />APPLICA�JF�,k�,� <br />ADDRESS: 3002 Iayw-S Q. s tm n,aLrle c�smy� Ca qC[��, <br />PHONE: DP g(ol =4M Z." FACSIMILE:_Cgirry) 51(DI`oY3o <br />TENTATIVE" APPOINTMENT DATE: it18 — Time: Iu:m Ar <br />(Piease allow 10 business days from date of application Submldal)rl. <br />S <br />Q CHECK BOX TO EXPEDITE REQUEST .$93-0 FE - REq EST PROCESSED IN 3 BUSINESS DAYS A - <br />SIGNATURE OF APPLICANTDATE Ilh�e i <br />�v Decartment Use Only 0 <br />CtN V ItttJl\NICIY I NL fl�nu n ver nn.... r... .....,— <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br />03 OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br />�L UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br />4WI40 <br />frl HA'ARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY O MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br />Co TATTOOJBODY PIERCING 17 POOUSPA O LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <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 (209) 464-0136 or mail to the <br />address indicated 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 be immediately available for review. -A nev <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 expenst <br />of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to reviev <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 <br />DATE CONFIRMED <br />REVIEWED 11 YES <br />TIME <br />PHONE FAX' INITIALS <br />NO REVIEW DATE <br />G.. .j- . tCt K CArtrasl l <br />