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PATE-RECEJVED EMD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> EN-YONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3d Floor Stockton;CA 95205 ' <br /> OCT 2 4 2 y <br /> 066)468-3420 Fax: (209) 464-0138 Web, www.co.san-joaquiii.ca.uslo-h'd' <br /> f-T"Xhf­)�10!'�[,AF 1'14'T i-i EALT11 4 <br /> P -"I i"F PUBLIC RECORDS RELEASE APPLI <br /> ?7P CANRC <br /> APPLICANT: a M&L—W BUSINESSIAGENCY-adMki 66!i0e ,20201 <br /> ADDRESS:32l o Gtl 6T �1py-,5;V0 15M N)c(Sro, CA-12% L3L <br /> PHONE:1(Z!L_2y&2-_3-207�__ FACSIMILE:_V1 3 55g(— 57P Z)b - <br /> TENTATIVE*APPOINTMENT DATE: Cr_77 20, Time: I_ -4 <br /> I QA1 <br /> (Please allow 10 business days from date of application submittal) <br /> VW /C'HECK BOX TO EXPEDITE REQS <br /> SIGNATURE OF APPLICANT 9"7E�7UE_rOCESSED IN 3 BUSINESS DAYS DATE <br /> e, T Department Use Only <br /> FILE ADDRESS UNIT <br /> I.- _S1r.QqVC4 BLCL14- 19- 18 5a Fr 11L E-1 Unit 1 <br /> Z S1.1 W. -11-1:!l S7k Ci!Y -not <br /> 3. Sireel tZ. 'RWESC1 W LA!; ty '35m. V VA El Unit 2 <br /> 4, Sv. I i All 4SIt., city iA_L <br /> 5. S., city <br /> .S U�Xo�_o 10 A)0 <br /> 6 V 10 <br /> 7. Scree: city Unit 4 <br /> a Street city <br /> 9 Streel city Unit <br /> Unit 5 <br /> 10 Street Ci <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> RIIDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 11 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> Er—UNDERGROUND TANK(moNrTORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> G"AZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> G-�fIERED PERMITTED FACILITY 0 MOTELIHOTEL 13 PUMPER TRUCKtYARDICHEM TOILETS <br /> 0 TATTOOIBODY PIERCING 0 POOUSPA 13 LAND USE APPLICATION SITES <br /> "EDICAL WASTE FACILITY 0 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)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 /> approximately five business days but no later than ten (10) days after receipt of application. The files <br /> will be hold 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 $93.00 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 /> EHD 46-02-006 <br /> ale/2003 <br />