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09/09/2004::;09:14 92528361 AEI CONSULTANTS) PAGE01 EMD LOG NUMBEi F��ID FILE ADDRESS 5AJoAQunv COUNTY >v ENwRoNMENTAL HEALTH DEPARTIVYNT SEP 0 9 2004 304 E Weber Ave 3"t Floor Stockton, n 95205 �003 (20, y) 468-3420 Fax: (209) 464-0138 Web: www.w-son Joaquinca.uVehd ENVIRONMENT HEA T PERMIT/SERVICES PUBLIC RECORDS RELEASE A-PPLICAVON APPLICANT: BUSINESSIAGENCY: I a6 r 5 caz C) -FACSIMILE: 995 of�V3 U191, � q,Ott nym.� t TENTATIVE"APPOINTMENT DATE: :l Time; 4" Ly n. (Please allow 10 busines6 days from date of application submittal 4' �/ l� 1 ka sued-ib� 1ro b ] as -1- EXPEDITE REQU ST •593.00 FEE - QUES ROCESSE N 3BUSINESS DAYS ACHECKsOXTO � SIGNATURE OF APPLICANT L U DATE of 0 Department Use Only ✓ ✓✓✓ 9 ENVIRONMENTAL HEALTH DEPARTMENT FILES UNDERGROUND TANK (UST) CLEANUP SITE (LOP) �( HOUSING ABATEMENT 1<SOUD WASTE FAC OTHER CLEANUP SITE (NON -Lop) ❑ FOOD FACILITY 0 SOLID WASTE VEH E 1.& UNDERGROUND TANK(MONITORINGIREMOVAL) U DOG KENNEL 0 DAIRY ] HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTELIHOTEL PUMPER TRUCKIYARDICHEM TOILETS O TATTOOIBODY PIERCING ❑ OTHER (PLEASE SPECIFY) LAND USE APPLICATION SITES C3 MEDICAL WASTE FACIL fTy - 1. List up to ten addresses in the space above. Select the type(s) of files from the list aboye 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 EHD staff may not be Immediately available for review. A nem 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 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. 6. Applications received after 3:00 p'm will be processed the next business day. l ❑ Unit 1 Unit 2 FILE ADDRESS 1. sneer 3011 a5i' McolleOR Unit a Cl S ,n 2. sed 3095- E. G k ON " :' e. so-eei 41 ^ (L _5A -%T,5 aw US Z Of 5 53 JW a, su"I_ n otz 5T A ES (Z s. sneer (SD WokA N. My Uri s. Slee4wt, NI L'�Ikoo Vvom r. so-ae StiIP N• W' aty" U T SCS e. sed a s screel a 10, so=d City ENVIRONMENTAL HEALTH DEPARTMENT FILES UNDERGROUND TANK (UST) CLEANUP SITE (LOP) �( HOUSING ABATEMENT 1<SOUD WASTE FAC OTHER CLEANUP SITE (NON -Lop) ❑ FOOD FACILITY 0 SOLID WASTE VEH E 1.& UNDERGROUND TANK(MONITORINGIREMOVAL) U DOG KENNEL 0 DAIRY ] HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTELIHOTEL PUMPER TRUCKIYARDICHEM TOILETS O TATTOOIBODY PIERCING ❑ OTHER (PLEASE SPECIFY) LAND USE APPLICATION SITES C3 MEDICAL WASTE FACIL fTy - 1. List up to ten addresses in the space above. Select the type(s) of files from the list aboye 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 EHD staff may not be Immediately available for review. A nem 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 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. 6. Applications received after 3:00 p'm will be processed the next business day. l ❑ Unit 1 Unit 2 Unit 3 Q Unit a *00 Unit 5 CONFIRMED APPOINTMENT DATE. TIME DATE CONFIRMED PHONE - FAX- INITIALS REVIEWED YES NO REVIEW DATE