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07/17/03 10:18 FAX 214 630 7070 HBC ENGINEERING f 001 <br /> GATEMeLn, 6 <br /> Eno LAG NUMER <br /> SAN N COUNTY <br /> ENVIRONMENTALTAL HEALTH DEPARTMEN' <br /> .JUL 1 % 21103 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 49 <br /> I r Li'll_1 H (209)468.3420 <br /> n,,,, 1 / , R 'ICiPAUBLIC RECORDS RELEASE APPL�IICDA,T�IO�N <br /> APPLICANT kk0a�G Y_ IM I-�� rO�cB�U�SIINESSIAGENCY 4kr_/,-,- I`n-+.2YRxt <br /> ADDRESS 'EID_ I CP�ps C r_�- � � <:S-( <br /> PHONE_ ILI—LOV7b— (OI O <br /> TENTATIVE'APPOINTMENT DATE 7 al 03 YIME DC7 <br /> (Please give 7 to 10 business days froL G e of application submittal) <br /> SaLI CHECK BOX TO EXPEDITE REQUF T-$89.00 FEE-1 RR�EQUES PROCESSED IN 3 BUSINESS DAYS u a ' <br /> 'SIGNATURE OF APPLICANT6 &is`- DATE <br /> v- <br /> THIS SIDE EHD STAFF USE ONLY <br /> FILE ADDRESS PROGRAM ELEMENTS SEARCH <br /> N Y - <br /> 10 <br /> 11to V� $ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT Cl SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) rl DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> E2 TIERED PERMITTED FACILITY 171 MOTELIHOTEL 0 PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOLISPA O LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY O OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space 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)4640138 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. 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 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$89.00 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 TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> ENO Aaaa.aN <br /> arxetaeea <br />