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Jan 03 05 10:03a Rob Nicholson 916-10-3073 <br />L_.. -- - —— P.2 <br />/DATE RECEIVED EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />i,(JE�.Vril) ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E Weber Ave 3 Floor Stockton, CA 95205 I <br />I of i 3 Z0, <br />Q509) 8-3420 Fax: (209) 464-0138 Web: www.co.san-joaquin-caus/elld <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Bob Nicholson BUSINESSIAGENCY: RNC Environatented <br />wnnoccc. 9746 Parktree Way, Elk Grove, CA 95624 <br />PHONE: <br />916-714-3073 <br />TENTATIVE' APPOINTMENT DATE: <br />FACSIMILE: 916-290-0106 <br />Time: <br />(Please allow 10 business days from date of application submittal) <br />EICHECK BOX TO EXPEDITE REQUEST -$93.00 FEE — REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT f�namfc.-- a4o:200aewd by 1.03R.nenAHlendwn DATE <br />Dam:2005.e1.030aoWd Nk <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />Department Use Only <br />I <br />FILE ADDRESS <br />1 <br />semen 1220 East Pine <br />cK, Lodi <br />z, <br />aeeer 1240 E Pine St <br />- Lodi <br />1, <br />y, t 213 South Kelly Street <br />c Lodi <br />4. <br />y,r 1220 Victor Rd <br />C Lodi <br />5. <br />seeel 32 N Cl ff <br />Lodi <br />s. <br />sneer 100 S Cluff Ave <br />Lodi <br />r. <br />yr,ee1700 S. Beckman <br />c Lodi <br />a. <br />sneer 9021ndustrial <br />C Lodi <br />a. <br />seCty <br />LAND USE APPLICATION SITES <br />10, <br />w l <br />CKY <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />Department Use Only <br />I <br />UNIT <br />❑ <br />Unit 1 <br />OTHER CLEANUP SITE (NON{OP) <br />FOOD FACILITY <br />Unit 2 <br />SOLID WASTE VEHICLE <br />UNDERGROUND TANK (MONITORINGIREMOVAL) <br />11\\ <br />Unt3 <br />HAZARDOUS WASTE GENERATOR <br />Unit 4 <br />❑ <br />20 <br />Unit _ <br />TIERED PERMITTED FACILITY <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) 464-0138 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 riles <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 will 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 />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 DATE TIME <br />DATE CONFIRMED PHONE FAX INITIALS <br />REVIEWED YES NO REVIEW DATE <br />rxo aeaxms <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />HOUSING ABATEMENT <br />%( SOLID WASTE FACBJTY <br />OTHER CLEANUP SITE (NON{OP) <br />FOOD FACILITY <br />SOLID WASTE VEHICLE <br />UNDERGROUND TANK (MONITORINGIREMOVAL) <br />DOG KENNEL <br />DAIRY <br />HAZARDOUS WASTE GENERATOR <br />CHICKEN RANCH <br />PKG TREATMENT PLANT <br />TIERED PERMITTED FACILITY <br />MOTEUHOTEL <br />PUMPER TRUCK/YARD/CHEM TOILETS <br />TATTOOIBODY PIERCING <br />POOLSPA <br />LAND USE APPLICATION SITES <br />MEDICAL WASTE FACILITY <br />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) 464-0138 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 riles <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 will 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 />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 DATE TIME <br />DATE CONFIRMED PHONE FAX INITIALS <br />REVIEWED YES NO REVIEW DATE <br />rxo aeaxms <br />