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NAN J OAQUIN COUNTY ,�,f = 1i EN*ONMENTAL HEALTII DEPART \ — 1 - - 304 E Weber Ave 3`d Floor Stockton, CA 95205 APR 1 5 Z(qp) 468-3420 Fax: (209)464-0138 Web: www.co.san-joaquin.ca.us/ehd F N!TH PUBLIC RECORDS RELEASEE AP/PLICATION y APPLK:ANT:\'��Pi/ttr BUSINESSIAGEE�NCY: ADDRESS: 3.j. ( A19� ,r/`OYi LarL 1 tY1I SL-vfC ,j�d -Jt q5625�� PHONE: Sia-6i6 BGG FACSIMILE: TENTATIVE'APPOINTMENT DATE: Time: (Please allow 10 business days from date of application submittal) ^ A �'- r,l Il Gli'v4 CHECK BOX TO EXPEDITE REQUES 393.0J0 FEE/-"EST LPROCESSED N 3 BUSINESS DAYS SIGNATURE OF APPLICANT 1J/LQ DATE IS 0` i Department Use Only FILE ADDRESS - UNIT ,. suee 3dZ3 ssf HW, i5z ( 1 2. co-ed 35 Ca vi 5 usl ❑ Unit 1 Stis�+xx- s. seed Lk f'PC ❑ Und2 _ s. seed 8Z5 l� r S usT aty PUnsurd 1 o ssaes3to CAY e, street - W usr14" s. Skeet _ G t S(•_ •._t 57- ❑ Unit 5 10. saed citi R 1 � ENVIRONMENTAL HEALTH DEPARTMENT FILES ,.. UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE Fl1CILITY ! OTHER CLEANUP SITE(NON4_0P) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY _ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH - ❑ PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS ❑ TAYrOOIBODY PIERCING ❑ POOL/SPA ❑ LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) 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 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 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. S. 'TENTATIVE appointment dates must be confirmed with EHD staff. w 6. Applications received after 3:00 pm will be processed the next business day. , CONFIRMED APPOINTMENT DATE..* TIME DATE CONFIRMED PHONE FAX INITIALS REVIEWED YES NO REVIEW DATE EHD"42-0M 40.2001 .