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08/ 16/ 2002 11 : 44 209 -F79-2225 MODESTO ATC PAGE 01 <br /> $kks lot <br /> SAN JOAQUIN COUNTYPU13LIC HEALTH SERVICES <br /> ENVIRONMENTAL, HEALTH DIVISIONED a 304 EAST WE9ER AVENUE, THIRD FLOOR U=�j � 1 � v <br /> STOCKTON CA 05202 <br /> (209) 46Bm3420 <br /> PUBLIC` RECORDS RELEASE APPLICATION AUG 18 2002 <br /> APPLICANT \�- rCW Qk UN BUSINCSSIAG12NCY krL tkSl jo la�+s ENVIR H <br /> ADDRESS 11l "a- l_Ja.n � a`v,A .AJt .n.rt PERMIT ICES <br /> � �IR S M���o Ca 7 5 3S 1 <br /> PHONE Z.069 �*Z " Z"t_`C l <br /> FACSIMILE z.Nt,9 51A - TL WL L T <br /> TENTATIVE' APPOINTMENT DATE c)t { zM-14 43 •L TIME _ 1 �0� <br /> (Plcasa Div 7 11 b� fro c of aP I alion :u6mitlaz) <br /> 0 CHECK BOX TO•EXPEDITE REQUEST • VAD F, -pp Y EgU�ESi �R0 0IRSINESS DAYS ' <br /> SIGNATURE OF APPLICANT V DATEII � I � � <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> t S4 5 �+� . Trot ¢ tl SkOtK4on m o t--� , <br /> 5 5 } a�4c ileo 0401 SiotbeM m o L✓ <br /> 12 Watt- as < ./A � at t4�cn"t Ma.><4tt � a <br /> 5j t+ µ ' %kWQ6 132 QvAilLUS . 4 <br /> }Sao U G5wit- W wr 5f Pec+, Teo m + A/ /1 <br /> i rtCV070 r w t r f p n B <br /> 1 Lt9 �caSF CS{+oCKAO.n u ,Z <br /> z1 C1 \ 4J Df �VL SA'qOCVA4Vl !s <br /> $tel iS1- Lrad� vtn.+t ��i o' <br /> A <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACIUTY <br /> Jai OTHER CLEANUP SITE (NON•LOP) 4 FOOD FACILITY 11 SOLD WASTE VEHICLE <br /> ❑ VNOCKGROUND TANK (MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> 13 HAZARDOUS WASTEGENCRATOR ❑ CHICKEN RANCH Q PKG TREATMENT PLANT <br /> ❑ TIERED PERMITr9D FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO)sODY PBIRCiNG ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL. WASTI FACILITY ❑ PusL10 WATER SYSTEM ❑ OTHER (PLEASE SPCCIr•Y ADOVE) <br /> 1 . List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> tfie appropriate box(es) . At least one file type MUST be selected. Fax to 2 9 464-0138 arm fl to the <br /> addressindicated above <br /> 21 CHD 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 ton (10) days after receipt Of application. The files <br /> will be hFld 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 roturnod in the samo condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Futuro file reviews by the same applicant may require a $ 07.00 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 <br />� TIME <br /> DATE CONFIRMED PHONE FAX <br /> INITIALS <br /> REVIEWEDYES - • <br /> CM o N e roe NO REVIEW DATE <br />