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11/08/2864 14:46 2094671118 AGE STOCKTON PAGE 01/0 <br /> i <br /> EKE)LOG NUMBER!, WEA.. Da SAN JOAQU eouNTx r <br /> ENVmONwN1cAL HEALTH DEPARTMENT <br /> NOV 0 8 2004 304 E Weber Ave 3'd Floor Stockton,6'�95205 70 . <br /> 209�}}468-3420 F>tix: (204)464-0138 Web;www.co.san-joaquin.ca.uslehd <br /> HEALTH <br /> PE. MU/SERVICES PUB IC RECORDS RELEASE AM C,ATTON s <br /> l.y <br /> APPLICANT, USlKESSIAQI NCY: tl <br /> r7 9 <br /> ADDRESS: JF <br /> PHONE:� �-7' �l! �f FACSIMILE, <br /> i r <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Plaaaa allow 10 business days from data of appllcaUo6 submRUQ 0w u[/� <br /> CHECK BOX TO EXPED[TE REQU - .00 FEE—REQUEST ESSE IN 3 BUSINESS DAY$ 1/ <br /> c �,4ao 9 <br /> /I <br /> SIGNATURE OF APPU ANT DATE <br /> Departrmnt Use Only <br /> FILE ADDRESS ? <br /> ,. streetUnit I <br /> � � <br /> 2 St-Ad I <br /> cC C tit <br /> a stree! r1"t 1 �ni#2n t <br /> 8, site&. <br /> Zocor ' Unit 4 <br /> B, Straw 11` <br /> a stoma city Unit 5 <br /> iR. Sfneel �� <br /> l� <br /> ENVIRONMENTAL HEALTH E)EPARTMENT FILES <br /> NDERGROUND TANK{UST)CLEANUP SITE(LDP) 0 HOUSING ABATEMENT � ❑ SOLID WASTE FACILITY <br /> THER CLEANUP SITE(MON-LOP) © FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONITORINGAEPAOVAL) 0 OOG KENNEL G DAIRY <br /> AZARDOUS WASTE GENERATOR C1 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL a PUMPER TRUCKIYARDICHE.M TOILETS <br /> • TATTOOIBODY PIERCING 0 POOLISPAI G LAND USE APPLICATION SITES <br /> • MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECI 1 <br /> I <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 selectedi Fax to(209146"1 aail to the <br /> address indicated above. <br /> 2. <br /> END will notify the applicant if any END files exist An appointml nt Or review will be confirmed <br /> approximately fire business days but no later than ten(10)days.!after receipt of application. The files <br /> will be held for a maximum of fire business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new <br /> application may be submitted when the file Is available, 1. 1 <br /> 4. Any file not returned in the carne condition as released will be reorganized by END staff at the expense <br /> of the applicant Future file reviews by the same applicant may require a$93.00 deposit prior to review. i <br /> 5. TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day. <br /> I� <br /> CONFIRMW AP.iiDiNTli iii DATP_: <br /> DATE,C4iNFIRMED. _ HC3N!*;', FAXJ 4".. :tN6Xl�A19 <br /> RMPMD-: YES :NO' / <br /> R j1 W" iri1'E . :. <br /> O 44-Q40 <br /> eHr <br /> i� <br /> I� <br /> t <br />