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\-1`1/06/04 MON 15:28 FAX 415 543 5480 TETR TECH EM INC SF� (JO <br /> 'PATE RECEIVED EHO LOG NUMBER <br /> \V- �° SAN JoI OUNTY <br /> ENwRoNMENTALHEALTaDFPAR.TwN1C <br /> 304 E Weber Ave 3`d Floor Stockton, CA 95205 <br /> J 209)468-3420 Fax: (209)464-0138 Web:www.co.san joaquin ca..&ehd <br /> 6 <br /> DEC I <br /> - , PUBLIC RECORDS RELEASE APPLICATION <br /> P U514F55lAOENGY: <br /> ADDRESS: 09 <br /> q (f PHONE: I G1, FACSIMILE: rrr���nnn rrr��� r <br /> TENTATIVE`APPOINTMENT DATE: Tlmo:_�,Qpntihitt–t L- 1�I' �D <br /> (Pleaso allow TO businms days from date of application snbmimari I�I(I�Uf����Ijy�,J�llJI���Lra' U <br /> CHECK BOX TO EXPEDITE REQUEST-59.A EROCES D IN 3 BUSINFSS DAYS I' <br /> SIGNATURE OF APPLICANT DATE � —16Z <br /> 0 <br /> Deparl,nent Use only <br /> FILE ADDRESS - UNIT <br /> ,. s,,,,,, W M.1 3 / p Unit t <br /> pl f'"fJ Vllt 2. $vee: W kr7 ;nze �F' GTI <br /> con' 1 S1 Ya <br /> Q/} �l;r o. so- 0 W eC:t„ I' 7- c cC" ❑ Unit 2 <br /> she 0 V^ d,',.Peri <br /> �l.��T 5. 6rrerrc ..f P L�1fr'" CHY <br /> 6. Strad N a c.f1 S z Ya <br /> y_ Unit 4 <br /> Irnlr Lq S-f e. <br /> 4N <br /> 0 E[1� <br /> unit 5 <br /> 4-a /R1 <br /> i / � N�� � RONATHDEPRTMENTFILES <br /> EAy <br /> NDERGROUNO TANK(UST)CLEANUP <br /> SITE(LOP) ❑ HOUSING P9ATEMENT ❑ SOLID WASTE FACILITY <br /> C( C)THER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> e,MNDERGROUND TANK(MONITOWNGIREMOVAL) ❑ DOG KENNEL 0❑ DAIRY <br /> m'HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILr Y ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARDlCHEM TOILETS <br /> ❑ TATTOOMODY PIERCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> • MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. Ust up to ten addresses In the space above. Select the type($)of files from the list above by checking M <br /> the appropriate box(es). j%t least one file type MUST be selected. Fax to(209)464.0138 or mall to the <br /> address Indicated above. <br /> 2. EHD vAl(notify the applicant If any EHD Tiles exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10)days after recelpt 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. Af(le that)s actively being worked on by END staff may not be immedlately available for review. Anew <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 /> U. Applications received after 3,00 pm will be processed the next business day. <br /> 00471hMED';4i4061NfiM> NT,RATE z'`5" TIME +^ .' <br /> 13ATE CDNFIRAtk`D PHONE . FAX ` ffdlTLA[.S ., .. :? <br /> "AbriEWED 1 ES NO REVIEW DATE. ' <br /> (i-r3'©u eftQc�yl� act 5`� �7I v / I PP <br />