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01 / 05 / 2005 09 : 56 2094E1- 1118 AGE STOCKTON PAGE 01 / 0 <br /> tt1U LVL+ NUNIMIN <br /> D SAN JOAQUIN COUNTY AVI <br /> a 005 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N 11 L 2 304 E Weber Ave 3`d Floor Stockton, CA 95205 I <br /> SAN 30A 11 ,FIIF69RX468 3420 Fax: (209) 464-01. 35 �cb : www.co.san joagmrin.ca.us/chd <br /> ENVIRONMENTAL HEALTH DEPT. PUBLIC RECORDS RELEASEI4PPI APPLICATION <br /> lisissinim <br /> :1 <br /> APPLICANT, <br /> C,3n 1,��.na�ru'� n - BUSINESS/AGENCY: " Advanced GeoEnvironmental, Ina - <br /> F- <br /> ADDRESS: _ 8$7 Shaw Road Stocl<tan CFl 95215 - <br /> 2U9-467-1006 FACSIMILE: 209467-1118 <br /> PHONE: _ ,_ --- <br /> TENTATIVE" APPOINTMENT DATE: Time: <br /> p-ry (Please allow 10 business daya from date Of appilcali submittal) - <br /> L--I CHECK 190X TO EXPEDITE REQUES 93.00 FEE "" REQUEST ROCESSED IN 3 BUSINESS DAYS / <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> Department Use Only <br /> Miss <br /> UNIT <br /> .�. AD RIESS <br /> hold <br /> eyrie Iva UnkI <br /> z rocL <br /> 17 11 0 C NINO <br /> c Sri a t0 <br /> a�91 235 W/ tvra c S Nrt ❑ UniteIF \ y� <br /> 4, Slroel t - r-+ C ;Umt <br /> / CilCIL 47. SIL'i t� VCi ,L Ylr4FD <br /> City IF <br /> steal c, ❑ Unit 5 <br /> to. slroel "_" C' <br /> l Nonni <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> R UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> IA OTHER CLEANUP SITE (NON"LOP) ❑ FOOD FACILITY Ell SOLID WASTE VEHICLE <br /> N UNDERGROUND TANK (MONITORINGlREMOVAL) ® DOG KFNNEL ❑ DAIRY _ <br /> M HAZARDOUS WASTE GENERATOR I CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYAROICHEM TOI LEIS <br /> O TATTOOIBOOY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY P OTHER (PLEASE SPECIFY) - <br /> i , Li up to ten addresses In the space above. Select the type(s) of files from the list above by checking <br /> the appropriate bo,s(es)" At least one file type MUST be selected. Fax to (2091464.0135 or mail tot <br /> address lRdLcatev° above, <br /> Y as <br /> view will be confirmed I <br /> -EHD will notify the applicant if an EHD files exist An appointment for re <br /> 7, us yThe <br /> approx?mately five business days but no later than ten (10) days after receipt of application. files <br /> Will be held for a maximum of five business days for review" Appointments should be schedu <br /> ed <br /> accordingly. <br /> A file that is actively being worked on by EHD stiff may not be immediately available for review" A new <br /> ' applicadon may he 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 /> OFF " i"ENTATIVE appointment dates must be confirmed with EHD staff. <br /> U" Applications rP.COWed after 3:00 pm will be processed the next business day" <br /> QG1101THlILiJ niy�?la(N7Mlv' i 15rW . ., "� . T1N1E: <br /> .'. pNC1lE .: : INITfALa <br /> I . .: FIF111b FIFE IF <br /> : . <br /> fiE1r3EVIlD . YDS: . . :: fd 7': REVIEW.DftTE <br /> stanaoa <br />