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09/08/2004'-:11:41 2094671118 AGE STOCKTON n � SAN JOAQUJN COUNTY ENVIRONMENTAL HEALTH DEPARTIiiffNT SEP 0 8 2004 304304 E Weber Ave 3rd Floor Stockton, CA 95205 ENVIRONMENT HEA68 3420 Fax: (209) 464-01.38 Web: www.co.san-joaquin.ca-us/chd LTH PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION ADDRESS: IQ /'J/Vf LTJ/ nv LKAQ p wc�Ly c� PHONE: 1207nI7b7 - —160& FACSIMILE: —42 TENTATIVE" APPOINTMENT DATE: !VzoLie 9 (Please allow to businasa days from date of application submittal) CHECK BOX TO EXPEDITE REQUE T.593.00 FEE – REQUEST CESSE IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT DATE Vca C01 ENVIRONMENTAL HEALTH DEPARTMENT FILES PAGE 01/0 EHD LOG NUMBER i Ala yN i a�Depadmnl Use Only uHITUnit ❑ Unil1 I—IVAN pq'bUnit 3 unit 4 ❑ Unit 5 . , , • 0 " 1 Traarr l� _,� "o 1111.1_��7 •�Tr1III 7rii� .,i ..�r� ❑HOUSING ABATEMENT SOLID WASTE FA OTHER CLEANUP SITE (HON -LOP) 0 FOOD FACILITY 0 SOLID WASTE VEHICLE UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL tfd V n r �"�•;:=ire. an-1.n,,.� HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT • TIERED PERMITTED FACILITY ENVIRONMENTAL HEALTH DEPARTMENT FILES PAGE 01/0 EHD LOG NUMBER i Ala yN i a�Depadmnl Use Only uHITUnit ❑ Unil1 I—IVAN pq'bUnit 3 unit 4 ❑ Unit 5 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) 464-0138 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 END 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 $93.00 deposit prior to review. 51 'TENTATIVE appointment dates must be confirmed with EHD staff. G. Applications received after 3:00 pm will be processed the next business day. On 1 0 " 1 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑HOUSING ABATEMENT SOLID WASTE FA OTHER CLEANUP SITE (HON -LOP) 0 FOOD FACILITY 0 SOLID WASTE VEHICLE UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT • TIERED PERMITTED FACILITY O MOTEUHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS O TATTOOMODY PIERCING O POOLISPA O LAND USE APPLICATION SITES 0 MEOICALWASTEFACILITY 0 OTHER (PLEASE SPECIFY) 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) 464-0138 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 END 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 $93.00 deposit prior to review. 51 'TENTATIVE appointment dates must be confirmed with EHD staff. G. Applications received after 3:00 pm will be processed the next business day. On 1