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X01/07/2004 HD 14:30 FAX Z002/002 <br /> u1,4(/LUU4 14:cl0 40 -00 r-NV 1KL-1NMt7-N 1 f-,- rr-JAL-I N <br /> " tt'fU LW n�nnv�,� <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> MD <br /> � ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3'd Floor Stockton, CA 95205 <br /> JAPE 07 2001 (249)abs-3420 Fax-. (209)464-0138 Web:vww,co.san joaquin-mus/ebd <br /> cNVIF;Ufdi/� a i icer i f PUBLIC RECORDS RELEASE APPLICAUON <br /> °Er fa^I f�55o-i(AZ1 S- <br /> APPLICANT: X��j� �f�f BUSINEs31AGENCY: <br /> ADDRESS //� �� Ir ST .2,4kEaw F(E LS E -- <br /> PHONE:�b6/) a7-067/ 7i�11�FACSIAAILE: <br /> TENTATIVE*AFPOINTME. T DATE: ZZ3-,&T Time: <br /> (Please allow 10 business days kotn date of appucatlnn submittal) <br /> lJ 10CK7IV 7—UE&P1 tY <br /> CHECK BOX TO EXPEDrrt_REQUEST•$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 7J <br /> Depwt Tmnt Use Only <br /> FILE ADDRESS UNIT <br /> sueel OS iQ S`TaC D ❑ Unit 1 <br /> 2. MrId IW5 AAV <br /> 3. '212LAv a. 1 Unit 2 <br /> 4. snit 03 Alqif y ,JAR. �tJ <br /> s. sacs Q6FY N� in 13 Unit <br /> o. sa.aL 19 0 / /l A -PR, l•' <br /> 7, strum / I mo-ee- 4Ft015 a 0295 G Unit 4 <br /> e. swd <br /> 191D zC4T0AJ Y <br /> nit 5 <br /> 9. SVeel <br /> 10. Strret <br /> ENVIROWII NTAL HMTH DEPARTMENT FILES <br /> �/ UP SITE(LOP) Q HOMING ABATEMENT MsOL10 WASTE FAC1Ln <br /> Il ERGROUND TANK(tJST)CLEAN a FOOD FACILITY O sOUD WAM VEHICLE <br /> ;'"OTHER CLEANUP SITE INON-LOP) <br /> * IJ14DFRGROUM TANK(MON 1TOR1NG/RFMOVAL) D DOG KENNEL C3 TR1AiMENT PLANT <br /> CI KAZARDOU'S WASTE GENERATOR <br /> a CHICKEN RANCN C3 DAJ pA1FtY <br /> O TIERED peMa1TTED FACILITY 11 MOTEL/HOTEt PUbtPER TRUCtvYARD/CHIAAA T01LET5 <br /> b TAT70 ODY PIERCING O PQOUSPA 0 LAND USE APPLICATION SrrE8 <br /> * MEDICAL WASTE FACIInY O 0-MFR(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one lila type MUST be selected. Fax to(2091 464 X138 or eftail to the <br /> address lindlicaled a ove- <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(1 o)days after receipt of application- The flies <br /> will be held for a maximum of live 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 nv <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 5Hdcxosffitapnorta revie <br /> of the applicant. Future file reviews by the same applicant may require a$ P <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 8. Applications received after 3:00 pm will be processed the next business day, <br /> GONFIWED OpO1NTMENT DATE 'GIME <br /> BATE GGNI'IRM]rO •PHONE FAX' . iNrr ALS <br /> FV <br /> REVIEWED •f• YES NO <br /> REVIEW DATE- <br /> 040 <br /> ATE040 44.02.006 y <br /> uertops - <br />