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06/26/2006 12:21 FAX Z 002/002 <br /> DATE RE-CEIVED SAN JOAQUIN COUN-ry <br /> ENNI :ON:'MENTAL 11EA,LTH DEFARA..,:,ENT <br /> '04 E Weber Ave 3`'Floor Stockton, CA 95205 <br /> (209)458-3420 Far: (209) 464-0139 NV,b: www.cosan-joaquin.ca us/e�d <br /> PUBLIC RECORDS RELEASE A PLICATION <br /> ^ BUSINESSIAGENCY: -- <br /> AP PL'acANi': - <br /> _ 4� �� FACSIMILE:_. ...�--- -----_ --- <br /> >��IONE: c:r<< / <br /> TENYATFVE*APPOINTMENT DATE. <br /> (Pieasc allow 10 busincts says from datc Of appliw,tinn sut"ttal) <br /> C3 CHECK BUY.TO EXPEWTE REQUEST,W.00 FEE—REQUEST PROCESSED IN]BUSINESS DAYS <br /> I� SIGNATURE O1= APPLICANT L16 DATE .r�(.2. <br /> Department U.W oniy <br /> UNIT <br /> FILE ADDRESS <br /> �. �, �`( tlge fLrJ..✓ Q �---- T [ Unit 1 <br /> Uni 2 <br /> .. sem_ 2-9 7 3 `� c U v\, "J <br /> s, s,2-, 27 (-UOM' ICS ✓✓ G U S 5 W r Unit 3 <br /> s. <br /> )r, G STS, ( Un't 4 <br /> G ' <br /> tic, Uri t 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES (P <br /> g UN TAt4K Ns CIwEAlVUP SR E(LOP) C] itOtJ51N'v AF3ATEMEtsi <br /> Iii.,Sousa WASTE FACILrrY <br /> L] FOOd FACI1..iTY C.1 .aOLICJ WASTE VESICLE <br /> L <br /> OTHER CLEANUP Sm(NON LOP) R DOG 1caNNs=t EL DAIRY <br /> UNOF_P:GRe7UND TANK(MONITORING[REMOVAI.) C3 CHICKEN RANCH ttl'-PKG'(RFATTdENr PLANT <br /> Al. HAZARMUS WASTE GENF-RATOR 0 HICKMOTE- .1N RAN. 0 PUMP:R TiiUGKI'A+tDlGI{ hR T41iFr i <br /> 13 TIERED PERMrriED FACILITY E:ln POOtJSPA M LAND USE APPLICATION SiTmS <br /> Q TATTGO ODo PIERCING Q OTHER(rtr,�-SE <br /> I] MEDICAL YJASTE FACILrTY <br /> 1• List up to ten addresses in the Space above, SCIect the type(s) of Flies?rorn the list'boko??y Ghecklnc) <br /> fi11e appropriate box(es). At least one file type MUST be selected. Fax to (20'3) a64-0�3.3.,or rn3i1 te��e <br /> .address indicated above_ app4intmcnt for review will be rcnfirtned <br /> 2. F_HD will notify the applicant if any ENC) files exist Anhe <br /> approximately five business days but no later than ten (10) days`fjvr fintrne.nts t cfshoi d 6eation.schcTedfsl,.s <br /> will be held for a marimtirn of five business days for review. App' <br /> accordingly. <br /> :i_ A file that is actively being worked on by EHb staff may not be irymediately available for review. A new <br /> application may be submitted when the file is available, <br /> 4, jvjy file not returned in the same condition as released will be reorganized <br /> �d Jtaff at the rssIt p"ior toYreview• <br /> of the appl(cant. Future file reviews by the same applicant may req P <br /> 5. -TENTATIVE appointment dates must be conrlrmed with EHD staff. <br /> r. Applications received after 3.00 pm wilt be processed the next business day. <br /> .TIME <br /> CONT:� M. D APPbiN r).lENT.t�AY.E: . .: . <br /> ;•DATE.Cp"t>=.I thfE� <br /> :PHON>^ FAX :� — <br /> YES t1J PEVIE'N DATE <br />