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_--027V3/2005 15:17 FAX 209 94606 (d 002/002 <br /> � SAN JoA.Qv'lrr Co•vivTx <br /> ENvrf o "IENTAL EEALTR DEPARTMENT <br /> FFR A ? 911,99 3D4 E Weber Ave 3'd Floor Stockton,CA 95205 <br /> HL'� <br /> ENVIRONMENT C1t1468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.ca-uslehd <br /> PERMIT/SERVICES pUBLIC PECORDS RELEASE APPLIC\AT..I�ON . <br /> APPLICANT. F f vj . `S,"StSD BUSINRSSIAGENCY_ 2.3r\, rte' <br /> ADDRESS: <br /> PHONE: 610 - L3L( FACSIMILE: <br /> TENTATIVE'APPOINTMENT DAM 7.1Ie� T1iG7 12;00 -- <br /> (Please sul is bminess days Item date of aPPIilalian subm1=0 <br /> © CHECK BOX TO EXPEDITE REQUEST-$97.00 FEE—REQUEST PROCESSED M 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT f✓7 <br /> DDecartrnent Use Only <br /> \' FILE ADDRESS <br /> UN <br /> V�•�r'YW ,. sv� � a cr+ p U Unit 1 <br /> 'VS T- t sv,d <br /> N/F saen iK a n 005 . <br /> a N, _ Unit 3 <br /> Q5 6. 9e b0aSL6Q <br /> f j w ,4S 7 Citya 4 <br /> \I uS <br /> e. sandr' <br /> v Vjr x 5vm o ]) ❑ Unit <br /> CW <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES o�fi <br /> IA UNDERGROUND TANK(VST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT IL SOLID WASTE FACILITY <br /> pi OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILrrY ❑ SOLID WASTE VEHICLE <br /> lEl, UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ nOG KENNEL 9-DAIRY <br /> Z HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 19L PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOBODY PIERCING ❑ POOLtSPA 2 LAND USE APPLICATION SITES i. . � <br /> ❑ MEDICAL WASTE FACILITY d OTHER(PLEASE SPECIM <br /> 1. List up to ten addresses in the space above. Select the type(&)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209146,4-0138 or mail to the <br /> address_indicated 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 ava)lable for review. Ane <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 expens <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to revie, <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm wilt be processed the nextbusiness day. <br /> 'n :-1 :.f�4 Y'....II J'.:. -4� `'V 3'.�.:�'wi�It_• :•��$.•V. <br /> �CQNF,� � AP,POItIfIV1.cN1'7'1A7F�`. •.,•`LIME d"��'-x _..err,--..• �.� r . <br /> w . <br /> 4THCQNFI.RE�; ,.PHONE • FAX <br /> 1tEVIESfJED ,= YES NO REVIEW DA7E. : ... <br /> ' cwn.n.naaae ' <br />