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NOV. 11. 2004 9:31AM CjWR EARTH TECH • N0. 1908 P. 1 <br /> �l� A"Rs I-�-�`I.' EHD LOG NUMBER�CE)VE( <br /> R SAN JOAQUIN COUNTY <br /> NOV 1. 7 2004 Epimo MENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`1 Floor Stockton, CA 95205 <br /> EIJVIR(iP";AtN I hEq468-3420 Fax: (209)464-0138 Web: www.co.san-joaquin.ca.us/chd <br /> A PUBLIC RECORDS RELEASE APAPLTCATYON <br /> APPLICANT: I'il u Pi,. ; BUSINESSIAGENCY: �onc>°or <br /> ADDRESS: IBS 6n,k "5IL C;�c41 5-4, I, 5-1v,L-Fon{ CA 9520co <br /> PHONE: &Of-431 FACSIMILE: z-01-7-34-0538 <br /> TENTATIVE'APPOINTMENT DATE: I Z I3 its OO4 Tim: `f:00 AM <br /> (Please allow 10 buslness days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93. E—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ^T�yJJ DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> spa 150 N. ncla r al S1ra..4-4-0n 11 -sq ❑ Unit <br /> 3. STM 1050 S. OI:V GI <br /> a. $e . O(s Em. Ma;n ❑ /Unit2 <br /> G 8bct /000 Ut)c l"v- G (] 1l V <br /> 6. Sural'1 O oGI V IP <br /> serer. 5 2-.SaE • Main rly Unit4 <br /> a sn� 5c,55 L <br /> 9. s�e.. 15'11 G I ❑ Unit 5 <br /> 10. Sireel <br /> ply I <br /> 4 z 32 e,. Mu•i h d' <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 0,up 44 to <br /> UNDERGROUND TANK(WTI CLEANUP SITE(LOP) O HOUSING ABATEMENT SOLID WASTE FACILITY <br /> W OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> 0UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL O DAIRY <br /> 9C HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOOWDY PIERCING 0 POOL/SPA `LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY O 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 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 he 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 condition 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 /> 6. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> TF1 . 11FlIMi' H't5 :%, FAX'ilii <br /> elioaaozaa <br /> awmos <br />