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83/25/2004 17:49 4159899934 _ ENVSF PAGE 02 - <br /> F 4400, <br /> RE'GtElt ,' --� "We EHD L00 NUMBER <br /> SAN JOAQUIN COUNTY <br /> MAR 2 6 2004 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton,CA 95205 <br /> ENVIRONMEWT HEAgh9)468-3420 Fax: (209)464-0138 Web: www.co.san-joaquin.ca.us/ehd ' <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE AP/P�LICAA/TI�Or�Nq <br /> APPLICANT: [,, BUSINEJ�4BSIAGENCY: F V V! <br /> ADDRESS: r I d1 =t� �7 Cc <br /> )- <br /> PHONE: '/ FACSIMILE: /�L <br /> TENTATIVE*APPOINTMCNT DATC: =l } i Time: 0:?z y w <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST•$93.00 FEE—REQQUUFT PROC SSED IN BUSINESS DAYS l <br /> SIGNATURE OF APPLICANT - "Af,' �/ G� ?� i DATE <br /> _ Department Use Only <br /> FILE ADDRESS t V I UNIT <br /> L4C1-&.f I H Ef o dgq D Lt c ❑ Unit 1 <br /> O-r 6011 L,4q 6LiF-- <br /> Unit 2 <br /> L r s zo 2(I ' c V <br /> uUnit 3 � <br /> So-ee Qc <br /> 00 -1 C1 - O c <br /> *� nit 4 <br /> 22 7 t U T street �7F Ci <br /> Use- `eves D G O Unit 5 <br /> 4ke A jig <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES APR ) 2 ZQ(4 <br /> "UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> a OTHER CLEANUP SITE(NON-LOPI ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> CGNOERDOUS W TANK GENERATOR <br /> ❑ DOG KENNEL O DAIRY <br /> Cl HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDtCHEM TOILETS <br /> ❑ TATTDO/GODY PIERCING rl POOUSPA ❑ 1 ANn 1 LCF APPI(CATION 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)464.0138 or mail to the <br /> address indicated above. <br /> 2. FHn will nntify 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 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 /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received atter 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 /> F D6e-0]406 <br /> PNJOOJ <br />