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03/25/2004 17/:49 415989c".34 ENVSF PAGE 03 <br /> Uno <br /> E'REItfEt}�,�l L� `� <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAR 2 6 2004 ENVIRONMENTAL IUALTH DEPARTMENT <br /> ENVIRONMENT304 E Weber Ave Td Floor Stockton,CA 95205 <br /> PERMIT/SERV 468-3420 Fax:(209)464-0138 Web: www.co.san-joaquin.ca.us/ehd <br /> PUBBLiIC RECORDS RELEASE A/PJP/L/ICAATION <br /> APPLICANT: BUSINESSIAGE CY: <br /> n <br /> ADDRESS: <br /> PHONE: { �(��/`l T/-l ^�� J FAA'C]SfIMIILE �j�� �I� '� ✓ <br /> TENTATIVE"APPOINTMENT DATE: (( 1.�`+fJ��i•/�i��` . Time: <br /> (Please allow 10 business days from date of application submittal) <br /> Q CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIONATUR12 OF APPLICANT 41?.41eI - j�� DATE <br /> Department Use Only <br /> FILE ADDRESS UNIY <br /> city ❑ Unit 1 <br /> 2. t !• CI �-O <br /> V m ❑ Unit 2 <br /> 4. 31 t G 6 /�/ y�Cf ! <br /> s. t �c G o7 A�lZUnit 3 <br /> v. s. ZZ w ef` 02� city3Sa <br /> C nr Ow Unit <br /> chyX955 ref <br /> Mv ❑ Unit 5 <br /> ,o. et ?S clix �- <br /> 7 124 Cji43S�g/co <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) p HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) Cl FOOD FACILITY ❑ SOiJD WASTE VEHICLE <br /> UNDERGROUND TANK(MUNI I ONING/REMOVAL) O DOG KENNEL ❑ DAIRY <br /> 17 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTIwL ❑ PUMPER TRUCK/YARD/CNEM TOILETS <br /> E3 TATTOOIBODY PIERCINC O POOL/SPA ❑ LAND USE APPY Ir.AY1f1N StTER <br /> ❑ MEDICAL WASTE FACILITY G 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. EHO 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 same condition as released will be reorganized by EHD staff at the exponsc <br /> of the applicant Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 5. *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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVILIW DATE <br /> eHo 4a•a3-WG <br /> 9AIR oa <br />