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\ TERRRCON - RENO :ax:775-351-2423 Nov 4 20 13:47 P.01 <br /> 21 SAN JOAQUINV COUNTY EHD LOG NUMBER <br /> NOV 0 4 2003 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3d Floor Stockton, CA 95205 <br /> _NVIRONMEj,d�J%a ffl-3420 Fax: (209)464-0)38 Web: www.co.san-joaquin.ca.us/ehd <br /> PERMIT/SERVICES <br /> —•r PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_ JCJ� Mc -E, BUSINESWAGENCY: -T &GON) <br /> ADDRESS:. /3 80 Gat& CT # 233 S P4f " IJy 8qV&j <br /> PHON S1 -2-40O FACSIMILE:=1'75-351-ZkZ3 ) <br /> cEl•Q '1'1 Pot, <br /> TMENT DATE: —r"r* NW 13 Time: 01"*tn= <br /> \ (Please allow 10 business days from date of appllcation submittal) <br /> rte/ X C.Ria4 � <br /> LL"`'�'. CHEZ`�K BO%TO EXPED EOUEST•59300 FEE-REpUE3 PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _922,U)r-r DATE <br /> U <br /> Dopartrnent Use Only <br /> _ FILE ADDRESS UNIT <br /> 1. slmat S. S "(, c LO y7 <br /> etre4 v3 QW51 SIT. c DT ❑ Unit 1 <br /> 0 1\ <br /> 4. 84oa N s'j. <br /> S. stroll o z W ALKLI - S-I . <br /> s e Uni <br /> a. slroalG R.C,l� S". <br /> B. Street 017 0 1 �J-t. �. 1\ _ Unit 4 <br /> w <br /> 9. 84n f 1f FI \�� <br /> 10. Street o1 C•,t;T.TR� Pl.�)I`l tIJ Unit 5 � /VA k, <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q i NDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT L°YSOLID WASTE F ■ <br /> HER CLEANUP SITE(NON-LOP) b FOOD FACILITY ❑ $OLID WASTE V '�` F' <br /> DERGROUND TANK(MONITORINO/REMOVAL) ❑ DOG KENNEL CI DAIRY > { ` <br /> T_'LIZARDOUS WASTE GENERATOR C3 CHICKEN RANCH 17 PKC TREATMENT PLANT <br /> �TATTOOIIEftED ERMITTERCING FACILITY 17 MOTEL/HOTEL ❑ PUMPER TRUCKfYARD/CHEM TOILETS <br /> O MEDICAL <br /> WASODY PIERCING d POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPEGIF`r) <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)4640138 or mail to the <br /> addr polcated 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 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$83.00 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 II-1 � -0 --3 TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD d!-07da6 1 <br /> arerzooz 1 _`f-�? NJQciC✓ri'P55 6C✓' (,/'1 v-wcl�i��� �Ur>'l.Q- .-C,105c'S ta -rr's5r 5 I7 5G L;[ N 7y/_ <br />