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04/05/2004 09:27 9252836121 AEI CONSULTANTS (SF) PAGE0 <br /> D rLE EVVEO+ - EHD LOG <br /> j SAN-JOAQMN COUNTY �.r <br /> 1M <br /> ENYiRoN-AmNTAL)E1EALTja DEPARTMENT <br /> APR 0 7 2004 304 E Weber Ave 3"d Floor.Stockton, CA.95205 <br /> VjRj Q09)468-3420 Fax: (209)464-0138 Web:www-co.san joaquin.ca.us/ehd <br /> EN <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: LAM71 hI BUSINESS/AGENCY: F N�1�n?1J7/t'f%Gl <br /> ADDRESS:�1 j e F <br /> PHONE:�1� i U� (�100� FACSIMILE:-9-05 oc -6 U[y <br /> TENTATIVE*APPOINTMENT DATE: `7 ISD`� Time: <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK SOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 DUSINESS DAYS �p <br /> SIGNATURE OF APPLICANT /`�"V DATE `� <br /> Depdrtrrwt Use Only <br /> © j FILL ADDRESS UNIT <br /> '7t— t. s 1(0051 (Q35 o a hoc e-4y 1 ❑ Unit 1 <br /> 2 v r IJ4 <br /> 3. ab, I1 <br /> -til Ce(ti}e+rE, Unit 2 <br /> CRYs. ft 25 5. CxAter St Unit 3 <br /> U <br /> 11 R <br /> Oty <br /> �n Unit 5 <br /> IQ. Street oty j+n <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING~ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SrTE(NON-LOP) ❑ FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 17 CHICKEN RANCH PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY d MOTFUH01 EL M PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTO01BODY PIERCING ❑ P00l1SPA AL LAND USE APPLICATION SITES <br /> C3 MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list aboye 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. Afile 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 /> 5- 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 5. Applications received after 3:00 pm will be processed the next business day. !� <br /> CONFIRMED APRO!NTMENT DATE- - ME <br /> DATE C(]NFI <br /> . RMEQ : _ `PHONE 'FAX - <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 49-0Y-006 <br /> t1lOJZ007 - - , <br />