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03/25/2004 - 17:49rr 415934 ENVSF PAGE '03 <br /> /51 <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> MAR 2 6 2004 ENVIRONNlENTA1 IUALTH DEPARTMENT <br /> 304 E Weber Ave 3`d Floor Stockton,CA 95205 <br /> ENVIRONMENT 1468-3420 Fax:(209)464-4135 Web: www.co.san joaquin.camFilchd <br /> PERMfT/S�RVI E <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> j t E <br /> APPLICANT: BUSfN STAGE CY /C� f y Z el-7 <br /> ql-i <br /> ADDRESS: �`"r ('2-0PHONE: ( '(r�/`l 0q^g4 53 _ FACSIMILE:' <br /> ACSIMILE: <br /> TENTATIVE"APPotNTMENT DATE: y � r Tiinr: L <br /> (Please aifow 10 buslnoss days from date f eppflcatton submtttal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAY$ <br /> 316NA7 UFtE Or APPLICANT �jri�Aii' ad <br /> t DATE <br /> Department Use Only <br /> FILE:ADDRESS UNI-r <br /> �. str Qlr <br /> city i a& �� Unit 1 <br /> 2. t tr U4. I atrD <br /> V m ❑ Unit 2 <br /> a. SI t G a /MAI <br /> s. t for 5fM1WG aff j tir= Unit 3 �7a CJ) <br /> �Unit4 <br /> r� c a.95S I1 <br /> 9_ O fA CRY ❑ Unit 5 <br /> � <br /> 3s'a'g/C0 <br /> ENVIRONMENTAL HEALTH DE IARTMENT FILES <br /> '61'UNOERGROUND TANK JUST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT Cl SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ 509-113WASTEVEHICLE <br /> UNDERGROUND TANK(MUNII ONINGIRFMOVAL) d DOG KENNEL 0 DAIRY <br /> G HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TR!_ATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY 0 MOTEUHOTI L 0 PUMPER TRUCKlYARf,]ICHEM TOILETS <br /> ❑ TATTOCA300Y MERCINC 0 POOLISPA rl LAND USE APP)lr:drinN RITFR <br /> ❑ MEDICAL WASTE FACILITY D 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 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 of the expanse <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 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 RE1!lLwM DATE <br /> Pip 44-OZ-WG <br /> ereaooa <br />