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NOV, 11.2004 9;31AM CQJ�,OR EARTH TECH 15� A��pCEIYED L` -L: � SAN JOAQUIN COUNTY NOV 1. 7 2004 ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Ave 3`4 Floor Stockton CA 95205 ��i iVIR;;f;IAcN (HL 468-3420 Fax: (209) 464-0138 Web: wwvv.ro.san-joaquin.ca.Us/ehd PFRP:IITI�ER.IC AA (� PUBLIC RECORDS RELEASE APPLICATION APPLICANT:_ft IR.1C DPz . i'f)- BUSINESSIAGENCY: iD{'IGTeDY ADDRESS: 188 >rYaniG U Je54 Civ! I, . Su_'4Io_ Z . ",/, J(. i A PHONE: ZA`I - LOI -'•f4 31 FACSIMILE: TENTATIVE* APPOINTMENT (Pieria allow 10 business days from date of application submittal) NO. 1908 P. 1 EHD LOG NUMBER CHECK BOX TO EXPEDITE REQUEST -593. SEE- REQUEST PROCESSED INS BUSINESS DAYS SIGNATURE OF APPLICANT DATE Department Use Only 117. -yam G. IV\a.t✓X %V ENVIRONMENTAL HEALTH DEPARTMENT FILES ❑ Unit 1 Unit 3 OV Unit 4 ❑ Unit 5 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT IS(SOLID WASTE FACILITY OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE J� UNDERGROUND TANK (MONITORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY 'JK HAZARDOUS WASTE GENERATOR D CHICKEN RANCH t1 PKG TREATMENT PLANT 9 TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKA'ARD/CHEM TOILETS t1 TATTOOBODY PIERCING 0 POQLISPA `'LAND USE APPLICATION SITES MEDICAL WASTE FACILITY O OTHER (PLEASE SPECIFIC 1. List up to ten addresses in the space above. Select the type(s) of files from the list above 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 EMD 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 new 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 pm will be processed the next business day. ;fi�tSNF' �'APP�+1N'T.NIENT�YkTI= .�j..�,';;•,,.. '>f':W.�Tl Qioosa2aae' "' ..t', emnom FILE ADDRESS sRe i50 N.ncla r GI Si'0 1 otn S 1030 S, 01,E GI ' 8. shoe 14 4) 0 - KAit 1 �_ GI ,. 5 ,.57_58 E . Ma.i" a, 5. sno. 5055 ir, cry o swm 51 I G E . Ma.�� GI 10. somal G �. 117. -yam G. IV\a.t✓X %V ENVIRONMENTAL HEALTH DEPARTMENT FILES ❑ Unit 1 Unit 3 OV Unit 4 ❑ Unit 5 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT IS(SOLID WASTE FACILITY OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE J� UNDERGROUND TANK (MONITORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY 'JK HAZARDOUS WASTE GENERATOR D CHICKEN RANCH t1 PKG TREATMENT PLANT 9 TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKA'ARD/CHEM TOILETS t1 TATTOOBODY PIERCING 0 POQLISPA `'LAND USE APPLICATION SITES MEDICAL WASTE FACILITY O OTHER (PLEASE SPECIFIC 1. List up to ten addresses in the space above. Select the type(s) of files from the list above 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 EMD 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 new 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 pm will be processed the next business day. ;fi�tSNF' �'APP�+1N'T.NIENT�YkTI= .�j..�,';;•,,.. '>f':W.�Tl Qioosa2aae' "' ..t', emnom