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NOV, 11. 2004 9:31 AM C OOR EARTH TECH • N0. 1908 P. 1 <br /> W LPaT R�cElvEO `- SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> NN 1. 7 2004 ENymoNMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton,CA 95205 I <br /> CIgVIR(ii`IINtN I HES 468-3420 Fax: (209)464-0138 Web:www.co.san joaquin.ca.us/ehd <br /> 3 <br /> pFR,rr,gT Q[F ti11C <br /> t / I� PU''rBLIC RECO"S RELEASE APPLICATION <br /> APPLICANT: AIQX L4.w X7!'1 BUSINESSIAGENCY: tot Ar <br /> ADDRESS: 1,e8 I~,,k� ujo54 (i,4 5c z S p S�DcL•AO"{( (A '157-0 <br /> (m <br /> PHONE: 21Jq-L01-4(.31 FACSIMILE: 209-2.34-0538 _ <br /> TENTATIVE'APPOINTMENT DATE:, IT /200�TIms: 92°O0AM <br /> (Plossa allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$9�E—REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT —�� DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> c spa 150 N. n far a. Si'o c l�_a-o ❑ Unit 1 <br /> 2. Sint 0 . N1o_z cily <br /> x. Sri 10 50 S. Olty at Il _4r /Unit2 -� <br /> 4. Sm: Otw E. Mow a '� <br /> 6. Siva 1'010 0 IIA)C <br /> � 1"V- city <br /> a. Sb e. ry D d Mi h Car V rH. <br /> T swr. 52-SSMain OW <br /> Unit4 <br /> B. swat OSS y• aly <br /> e. swr. .-5-11 G I\/�o-in ct ''� _ ❑ Unit 6 <br /> e • 1\Aa.1 v� y �1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �Aef <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT 1<80LID WASTE FACILITY <br /> W OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 13 SOLID WASTE VEHICLE <br /> 0UNDERGROUND TANK(MONrroRINGIREMOVAL) D DOG KENNEL ❑ DAIRY <br /> 'X HAZARDOUS WASTE GENERATOR D CHICKEN RANCH tJ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY O MOTEL/HOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> M TATTOOBODY PIERCING 0 POOL/SPA `ra'LAND USE APPLICATION SITES <br /> El MEDICAL WASTE FACILITY O OTHER(PLEASE SPECIFIC <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 selected. Fax to(209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant If any EMD 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 same condlUon as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 8:00 pm will be processed the next business day. <br /> +4'.t',1KI#+; #�:A13PfJlN7)%EN17D9Y71= '`)'jihlt�•e;., F. <br /> Air '�;g1aFl.AU6I Iib)( C'ti .;; JNJfY(lCS <br /> nr , <br /> tVI�VJC •D ���• �Ntti.'I .C��kf1V,�C7�kTE`• ,. . . :'�< <br /> Eroasaz-0ae <br /> uareaos <br />