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FROM : Geo—Phase Environmental <br /> *owl <br /> C. FAX NO. 2095690295 Sep. 18 2003 03:22PM P2 <br /> �d <br /> • EHD LOG NUMBER <br /> DATE RECEIVED• <br /> �jr-=, SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTIVIENT <br /> SEP 1 8 2003 304 E Weber AVC 3 T 6 door Stockton, CA 95205 <br /> 0 <br /> (209)468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.ca.us/ehd <br /> ENVIRONNMENiEN' HAELTH <br /> PERM T`I, L PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: `T AV rC( UUSINESSIAGENCY: & ��fDyt� <br /> ADDRESS:�� 3 7 L/P 444 4U Z--" V — <br /> PHONE: 6 7 Cp 0�,!22 FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: �� 7 Time: <br /> (Pleaso allow 10 business days from date of applicatlon submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00,FEE—REQUEST PROCESSED IN 3 BUSINESS PAYS <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> 9 �� <br /> Department Use Only <br /> c;k IG 1 FILE ADDRESS UNIT <br /> t, str�� G ko. r a d Unit 1 <br /> z. Sunt Gt -, k; Sa-,�q <br /> 3. Street 11/ C �-.G/ [I unit 2 tU <br /> 4. Street G <br /> s. sheet c' Unit 3 -�4Gi�� <br /> 6. Street G <br /> 7. Street Unit 4 <br /> B. 6treel p <br /> 9, street at ❑ Unit 5 <br /> 10. Streot G <br /> ry <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING ABATEMENT C1SOLID WAS <br /> F IL <br /> OTHER CLEANUP SITE(NON-LOP) M FOOD FACILITY 13SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH Q PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL [J PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOOIBODY PIERCING a POOLISPA ❑ LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FAG►LITY 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 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$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 /> 7. <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 4e.0•006 <br /> 916/2003 <br />