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08/09/2007 THU 15;04 FAX 209'999 SJC PUBLIC WORKS * X001/006 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`d Floor Stockton,CA95205 <br /> (209)468-3420 Fax: (209) 464-0138 Web: www.cosan Joaquin-c _ s 1 <br /> 1 <br /> In <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Claudia Gemberi.ing BuswEsvAGENcv: San Joaquin County Public Works Department <br /> ADDRESS: 1810 E. Hazelton Avenue, Stockton, California 95205 <br /> PHONE: 953-7624 FACSIMILE: 468-2999 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST•/593.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS Q n <br /> SIGNATURE OF APPLICANT /'if Q.({- /Cf„ K.fL.`jff_�� DATE <br /> t! Depart nenl Use Only <br /> _ FIDE ADDRESS UNIT <br /> 1. seen DS Af W4 W - Sf ON O Unit 1 - <br /> z. SQ.w b i bn W4 UN I At'. <br /> S 2Dtoo G •F• Unit <br /> 4. I.M X0&17 Q, o \ <br /> s. 31n:e( O c T /r Unit 3 t� <br /> e. strew" '" <br /> >- SU t 9,9 1 P Unit <br /> e. suael c <br /> sass �I , /F El Unit 5 <br /> 10. 5V ( �1 raid Gi .I- <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 11 SOLID WASTE FACILnY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY x SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) d DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH '�j.,PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY E MOTELIHOTEL D PUMPER TRUCKIYAROICHEM TOILETS <br /> TATTOOIBODY PIERCING 0 POOL(*FA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WkSTE FACILITY M OTHER(PLEASE SPECIFY) <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 rile type MUST be selected. Fax to(209)464-0138 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 available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the some condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the some applicant may require a$93.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> --- 8_ --—tppiivafionsTeceived�fter3:OO pm�vili begsr c dthe next business day. <br /> CQNF�RMED A7F�OINTNIENT DATE: TIM <br /> DATEDONE(RMED PHONE FAXN(TIALS: <br /> -REV. YID' . Q R ViCW[iQ7 E <br /> :_ --- <br /> ENO ae-uxm5 ' <br /> slymot <br />