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Rud 29 03 11 : 30a Karen Fitzmaurice 61,37-5731 p. 3 <br /> �- N,_,r ; <br /> DATE REGE[�O 1f ��; F a EtJ P.01'U IE{ITS LN1fF=F� P.'.GE 01 <br /> SAN JOAQL'FN COUNTY EHO LOG NUMBEP. <br /> AUG 2 9 2003 ENVIRONMENTAL HEALTH DEPARTMENT <br /> � UNMENT <br /> 304 E Weber Ave 3'd Floor Stockton,CA 95205 <br /> PERMIT/SERNEEW468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.causlehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ISA'-'A -�Z1yiAL,l,VI !j—L_^0USINESS1AGENGY. S_Yp <br /> ADDRESS• 11441 r P Q <br /> l$ A <br /> PHONE: � '` 4 3 FACSIMILE: {� --y 37— 5-731 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from dat of application submittal) <br /> In CHECK BOX TO FXPE DUE REQUEST-$93.00 FEE-REQUEST PROCESSED IN a BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department use Only <br /> FILE ADDRESS UNIT <br /> T. srnpr Poo 5. G �. O ` . 711 <br /> Unit 1 <br /> z. sme�r 11a 1 r ci n <br /> s. sal a <br /> it 2 <br /> C. slreel <br /> S. SIT-t c4ty Unit 3 G\ <br /> 6. sinret - Gr (-I I <br /> 7. Wm Ch Unit 4 -� <br /> Is. StreetCRY <br /> 9 Stre91 Ci h nit 5 <br /> 10. sneer Ct 44 <br /> f <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UI�I,JNOERGRDUND TANK(UST)CLEANUP SITE(LOP) +r3"HOUSING ABATEMENT � SPLID WASTE FACILCTY <br /> gTHER CLEANUP SITE(NOH-LOP) 4 FOOD FACILITY OLID WASTE VEHICLE <br /> �@p// DERGROUND TANK(MONITORINGMEMOVAL) 0 DOG KENNEL D DAIRY <br /> 0 �ARDOUS WASTE GENERATOR t>YCHICKEN RANCH Ci-PKG TREATMENT PLANT <br /> I/TIERED PERMn"TED FACILITY M MOTELfHO'tEL M- MPER TRUCKIYARUICHEM TOILETS <br /> ❑ ATTOOIBODY PIERCING ❑ POOLISPA Er- AND USE APPLICATION SITES <br /> tVMEDICAL.WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> I. List up to ten addresses in the space above. Select the type(s) of tiles 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 tot <br /> address indicated above. <br /> 2. EHD will notify the applicant If any EHD files exist. A I appointment for review will be confirmed <br /> approximately five business days but no later than to (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 I TIME <br /> DATE CONFIRMED PHONE � FAX INITIALS <br /> REVIEWED YES 140 REVIEW DATE, <br /> EM uA7-0os <br /> ALIG-23-2003 FRI 11:51AM IL-1: PA'75E:2 <br />