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02/05/2007 M08:39 530676Faq5 STRATUS NO CALIF PAGE 01/01 <br /> V © _..._.._...-.. �..� PAGE Bl <br /> SAN JOAQM COVNW UNU`V"" '"°"` <br /> F-NvJR0NmNTAL HEALTH DEPARTr ENT <br /> FEB 0 5 2007 304 E Weber Ave 3'�Floor Stockton,CA.95205 <br /> (209}}�468-3420 Fax. (209) 464-MIS Web:www.co.san joagdiMcaus/ehd ✓J <br /> ENVIRONMENI HEAM <br /> PEWT/SERVICES _PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: -/ _ P f TYir.r,R� s fra/f'S U of l <br /> BUSINESS/AGENCY: __ l~rM,ypg�n <br /> ,�AnbRESS:3330 C cramr�dl,{c pr. SU;, Ssv , C4h1PNy1 <br /> l •7�--- -----, <br /> HONE: S�`f01�D' aUUfoZ pAC91MILk:_'n�rr 7tt�0� 6405 LI <br /> TENTATIVE'APPOINTMENT DATE: Pme ( { ro Stt Time: <br /> (Please allow 10 business days from data of application submittal) <br /> CHECK 13OX TO EXPEDITE REQUEST•$43.00 FE QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �LA � DATE 2-2�97 _ <br /> Department Use Only <br /> ` FILE ADDRESS UNIT <br /> I. sbe 05 Cour C(,4 Blvd. 5 uS7' HW <br /> a s ❑ Unit 1 <br /> 9 9 eM <br /> ` M Q Unit 2 <br /> a sacci <br /> e. stun a t) Unit 3 <br /> f s °" cay Unit 4 <br /> e. svaM <br /> s ❑ Unit S <br /> 10. s-• <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK tIrST)CLEANUP SITE(LOP) d HOUSING ABATEMENT C SOLip WASTE FACILTIY <br /> d OTHER CLEANUP SITE(NONd.OPi d FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> IINDEROROUND TANK(MONROWOG/REMOVAL) d DOG KENNEL DAIRY <br /> HATARDOUS WASTE -E ERATOR d CHICKEN RANCH d PKG TREATMENT PLANT <br /> Q TIERED PERMITTED FACRITY C3 MOTELMOTEL d PUMPER TRUOMARDICHEM TOILETS <br /> ❑ TATTOO>BCoy PIERCING 13 PODIISPA A LAND UseAPPLICAVON SrrEs <br /> d MEDICAL WASTE FACILITY Q 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 checWng <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)40:9138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant H 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 avallable_ <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 review's by the same applicant may require a$93.00 deposit prior to review. <br /> 5, "TENTATNE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIPMED APPOINTMENT DATE 7 TIME <br /> DATE CONFIRMED PHONE . FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> e9w w . <br /> eldZpe9 <br />