Laserfiche WebLink
03/25/2004 .17:49 4159899934 ENVSF PAGE 01 <br /> R4 <br /> rte, <br /> SAN JO.AQUIN COUNTY <br /> MAR 2 6 2Q04 ENVIRONMENTAL HEALTft DEPARTMENT <br /> 304 E Weber Ave 3"`Floor Stockton, CA 95205 q7 <br /> ENVIRONMENT H480046$_3420 Fax: (209)464-0138 Web: w I co.sanjoaquin.ca.us/ehd 17 <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; N BG <br /> USINESS! rNQY-. 1 j �(/ I/ <br /> ADDRESS: <br /> � �jl (� T DI ✓L`/�."�I�/I �/� 7co <br /> PHONE: L=_E 71 .1 'T, l FACSIMILE: <br /> TENTATIVE*APPUINI'MENI VAIL: ; n �) Time; <br /> (Please allow 10 business days from datelafappl[catlon submittal) <br /> CHECK BOX TO EXPEDITE REQUEST•$93.00 FEE—RE]UEST PROCESSED IN 3 BUSINESS DAYS 4 <br /> SIGNATURE OF APPLICANT P/ �' � J� � DATE r <br /> Partrnent Use Only <br /> FILE ADDRESS UNIT <br /> nit 1 <br /> `So7 <br /> 1 I 5O <br /> Unit 2 �r <br /> ea, c f � Unit 3 � �l <br /> r.l. l <br /> 6. of Van pati C <br /> ,. 9+ t n • 'k�,p � � unit <br /> I <br /> -17-o r _ c I <br /> adz 95 44 e <br /> !♦ �P c. �t I AJ# S ❑ lJnit 5 <br /> r z C I <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 0'UNDERGROUND TANK(UST)CLEANUP SITZ=(LOP) 0 HOUSING ASATEMENT, © SOLID WASTE FACILITY <br /> 0 OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY CI SOOD WASTE VEHICLE <br /> a UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL M DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH I Cl PKG TREATMENT PLANT <br /> a TIERED PERMITTED FACILITY ❑ MOTELIHOTEL © PUMPER TRUCKWARDICHEM TOILETS <br /> Cl TATTQolsoDY PIERCING 4 POOLl;,PA I 4 LAND USC APPLICATION SnIES <br /> 0 MEDICAL WASTE FACILITY o OTHER(PLEASE SPECIFY) <br /> 1. List up to ter+addresses in the--pare 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 appiioant If any END files oxist. An Iappointrnent for review will hP 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 fila 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 a8 releasedI will be reorganized by EHD xlarr at the expense <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 I TIME <br /> DATE CONFIRMED PHONE FAX INITIALS _ <br /> REVIEWED YES NO REVIEW DATE <br /> I <br /> EHD 4&02-069 <br /> 9f IMI . <br /> I <br /> I <br />