Laserfiche WebLink
3/02/2004 12:09 FAX 20> 80621 i <br /> DA002/002TE RECEIVED Il <br /> LRRECEIVED <br /> � 1\\//I� SAIL JOAQUIN COTINTX <br /> L�C EI V E� ENVIRONMENTAL HEALTH DEPARTMENT <br /> , 304 E Weber Ave 3rd Floor Stockton, CA 95205 n <br /> MAR 0 2 2004(209)468-3420 Fax: (209) 464-0138 Well,www.cosan joaquin.ca.us/ehd �Iv/ <br /> EiVVIRGViVENT HENIIjH <br /> P �11PUBLIC RECORDS RELEASE APPLICATION <br /> CDn�ITICCRr1=_� <br /> APPLICANT: .KF�i� STAB BUSINESSIAGENCT:`Lu <br /> K <br /> ADDRESS: �I1 -1 r SWL4Z1 t <br /> PHONE:_ IK � �� FACSIMILE: att(�� b6-t-t <br /> TENTATIVE'APPOINTMENT DATE: -511-1-1 0 y Time: 1-400 <br /> (Please allow 10 business <br /> � days Tram date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-f93.0O FEE-•REQUEST PRO ED IN 3 BUSINESS DAYS <br /> I. <br /> SIGNATURE OF APPLICANT DATE 112104 <br /> �; Noa6Twd Use Only <br /> I' FILE ADDRESS UNIT <br /> s RA S 1. WO <br /> a s vICW E] Unit1 <br /> a. iq Z S / Unit 2 <br /> s, seen 2 R w � V+' <br /> e. secs S l 4A. W t• X-.011 <br /> �Unit 3 ✓( N'/I Gl <br /> city 0 A)o �ZU / V <br /> �. seen M <br /> Logx4E,6pgb Ste, U 4 <br /> F__ " tt L•T- 9 AL 1fi0 <br /> 9. Seeei I� . <br /> DIV <br /> 10. S4eM <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Ar UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT B) SOLID WASTE FACILITY <br /> SC OTHER CLEANUP SITE(NON4.OP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> 'W UNDERGROUND TANK(MONtroFuNGIREMOVAL) ❑ DOG KENNEL W DAIRY _ <br /> Or HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH a PKG TREATMENT PLANT <br /> ❑ TIERED PERM fTTED FACILM ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YAROICHEM TOILETS <br /> ❑ TATToomoDI--PIERCING ❑ POOUSPA 19 LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY D OTHER(PLEASE SPECIFY) <br /> 1. Listup 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)464-0138 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 /> appSoximately 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. AnIfilenot returned In the same condition as released Will be reorganized by EHD staff at the expense <br /> of A;a applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review <br /> S. '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 /> i. <br /> ON'F:If2MED.APPOINTMENTTiATE 'i - TIME y4 tF <br /> DA,TECONFRMED ;'.PHONE FAX ilNllALS <br /> .REVIEWED .i YES `N0 REVIEW DATE; <br /> Elle 0E 240 I, <br /> ererzeo� l - - <br />