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Jan 03 05 10: 03a bert Nicholson -714-3073 P• 2 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT I �� <br /> 304 E Weber Ave 3rd Floor Stockton, CA 9520 <br /> 0n5 aa <br /> us/ehd <br /> lap; 3 <br /> 20Q209) 8 3420 Fax: (209)464-0138 Web: mnvw.cosan joaq <br /> Lir <br /> _ PUBLIC RECORDS RELEASE APPLICATION <br /> Bob Nicholson RNC Environmental <br /> APPLICANT: BUSINESSIAGENCY: <br /> ADDRESS: 9746 Parkhee Way,Elk Grove.CA 95624 , <br /> 91(-71.¢3073 FACSIMILE: 9t(r290-0106 <br /> PHONE: <br /> TENTATIVE'APPOINTMENT DATE: <br /> Time:�— <br /> (please allow 10 business days from date of application submittal) <br /> FICHECK BOX TO EXPEDITE REQUEST.$93.00 FEE—REQUEST ROCES EED IN 3 B SINlESS DAYS <br /> =:2aoso,.o3 os:a:sr-0e•ar DATE <br /> SIGNATURE OF APPLICANT Department Use only <br /> UNIT <br /> 7iw <br /> t. 1220 East Pine ❑ Unit 1 <br /> s s.:ec 1240 E Pine St <br /> a � 213 South Ke11Y StreetUnit 2 i1\\ <br /> 4 st, 1220 Victor Rd s � 32NCIuff Unit3 <br /> 1Do S Cluff Ave <br /> s. s <br /> ere Lodi Zg 1K,r„ ,fJ Unit 4 <br /> Beckman c _ <br /> e. s,eec 902 Industrial c Lodi N•r< - <br /> ❑ Unit 5 <br /> ' M <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> HOUSING ABATEMENT X SOLID WASTE FACILITY <br /> UNDERGROUND TANK(USI)CLEANUP SITE(LOP) FOOD FACILITY SOLID WASTE VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) DOG KENNEL DAIRY <br /> UNDERGROUND TANK(MONITORINGRtEMOVAL) CHICKEN RANCH PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR MOTEUHOTEL PUMPER TRUCKIYARD/CHEM TOILETS <br /> X TIERED PERMITTED FACILT' POOLISPA LAND USE APPLICATION SITES <br /> TATTOO/BODY PIERCING OTHER(PLEASE SPECIFY) <br /> MEDICAL WASTE FACILITY <br /> 1. above. Select the types)of files from the list above by checking <br /> List UP to ten addresses in the space <br /> the appropriate box(es). At least one file type MUST be selected• <br /> Fax to rxwt q64-D738 or mail to the <br /> addressindicated above. ill beconfirmed <br /> 2, EHD will notify the applicant H any EHD files exist An appointment for review wcThe files <br /> approximate) five business days but no later than ten(10)days after receipt of app <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. at the <br /> 4 of the applicant. Future file retviews by the same apple ocriditionas released ill becant may require a$93y 0 deposit prior toxreev eW. <br /> 5. *TENTATIVEappointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> =CONFIRMED <br /> ETIME <br /> PHONE FAX INITIALSNO REVIEW DATE <br /> FRo+aoeoos <br /> ererlooa <br />