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09/13/2004 11:53 FAX 209 94801 / / Q002/002 <br /> SEP 13 10.4 11:19W CoMuD ENGIPEERIMG `•i <br /> P.1/1 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY EMD LOG NUMBER <br /> ENVIRONMENTAL HEAD'S DEPARTMENT <br /> __- 304 E Weber Ave 34 Floor Stockton, CA 95205 <br /> (209)469-3420 Fax: (209)464-0239 Web;www.cosan j0aquin.0a.us/ehd <br /> PUBLIC RECORDS RELEASE 'APPLICATION <br /> APPLICAN'T' OALBUSINESS/AGENCY <br /> ADDRESS: <br /> CA !15 206h <br /> PHONE.• 1328 7 FACSIMILE: 09C q32_ A777 <br /> TENTATIVE"APPoINTmENr oATE: 'Pane: <br /> (Passe allow 10 business days from date of applica0en rubmittaq <br /> 0 CHECK BOX TO EXPEDITE REQUEST.393,00 - PROCESS 1 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT al 11 UDATE 1 Q <br /> DePwIment Use Only <br /> FILE ADDREs$ UNIT <br /> j '' �, „ ❑ Unit 1 <br /> ' "" ❑ Unit 2 <br /> .. <br /> aaa <br /> city ❑ Unit 3 <br /> _ r a <br /> ❑. Unit 4 <br /> e. d4jiho <br /> CRY ❑ Unit 5 <br /> 0 ENVIRONMENTAL HEALTH DEPARTMONT FILES <br /> kf UNDI5R6ROUN0 TANK(UST)CLEANUP SiTE(LOP) D HOUSING ABATEMENT M,SOLID WASTIE FACILITY <br /> D OTHER CLEANUP SITE(NON4") G FOOD FACILITY D SOLID WASTE VEHICLE <br /> 0 UitDERMOUND TANK(MONI TORNGMEMOVAL) D DOG KENNEL 0 DAiRY <br /> O NA7/URDOU3 WASTE ORATOR d C14101 RN RANOW C3,PKG TREATMENT PLANT <br /> D nERED PGRIINTTED FACUMV Q MOTEL&Ioym M PUMPER TRUCKMARDICHE14 TOILETS <br /> D TATTOOANWY PIERCING o POOLISPA 12 LAND USE APPLICATION SITES <br /> D MEDICAL WASTE FACILITY D OTHER(PLEASE SPECIFIfr <br /> 1. List up to tan addresses in the space above. Select the type(s)of filen 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 /> �In e- <br /> t. EIOioant If any EHD files exist. An appointment for review will be confirmed <br /> 4pproximatey five business days but no later than ton(10)days after receipt of application. The files <br /> will be held fdr a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is aetivey being worked on by RHO staff may not be immediately available for review. A new <br /> application may be submitted when tho file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by WHO staff at the expense <br /> of the applicant Future fife reviews by the same applicant may require a$93.00 deposit prior to rWkw. <br /> 5. 'TENTATIVE appointment dates must be confirmed with END staff, <br /> 6. Applications received after 3:00 pm will be processed the next business day, <br /> CON!mfr APPOIMTMENT DATE - <br /> BATE CON14RMED Post it Fax Note 7671 Pate 4% I'� 04 Pip 1 <br /> REVIEWED YES No T' o u NeaC P1 D11 , ore. c b o <br /> a� Calo.P.V<V-%40- Cie-r, Ce. C <br /> a pwrma F=s 937-8787 <br /> axe 4• -Od �`" ct'57-877 <br /> 09/13/2004 EDN 11:16 [TZ/RX NO 72731 ®001 <br />