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x09/ 20 / 2003 14 : 37 92528 " - 21 AEI CONSULTANT SF) PAGE 01 <br /> 09/ 15/ 2803 12 : 45 4640 1 ., 0 ENVIRONMENTAL I-�ALTH PAGE 01 <br /> DATE RECEIVED ern+ �w i.�mocn <br /> vv �7 r� SAN O 'S' <br /> AQUINCOUNT <br /> 11 '' I ENVIRONMNTALREALTxDEPAiT mENT - <br /> SEP 2 2 304 E Weber Ave 3'd Floor Stockton, CA 95205 <br /> ( 468-3420 Fax: (209) 464-0138 Web: www,co.san joaquin.ca.us/&d <br /> EN\IiRONPABI HEAD H <br /> nr '+ M1n �TI~i= R�n � FS �j.TRLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: { 1 'C, 2 o14 /ey BUSINESS/AGENCY: <br /> ADDRESS:: �rak500Dtdolo Slaid e 00 UJOL 0- L4 <br /> PHONE: �./ _,�t000 �, FACSIMILE: _ 4�jejC;; (o I <br /> TENTATIVE" APPOINTMENT DATE: °1 d I o I I� 6 3 Tlme; <br /> . (Plcaoc allow 10 busbies days from data of appllvation submlttal) <br /> CHECK BOX TO ExPRE) ft/Eg SE <br /> EST 93. FEE - UEST PROCESn IN 4 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN f _ _ a^ DATE Ij 010 -F. <br /> Depaml t Use Only <br /> FILEADD UNIT <br /> i1 srcm o ! G �� (' fi ❑ Unit 1 (L <br /> Unit ?��9)d ✓ m a el 320 o sl et ell <br /> Uit3s. rce 10 . i a U n <br /> B. 91RLt G <br /> sem, r cVXK Unit 4 <br /> 8. Slrtel CI <br /> s sue¢l CI ❑ Und 5 <br /> 10. Sheet C,1 . <br /> �( �ncln Com ( llrtc II ? n� s , I-rt15617 r �s <br /> sib c ylpYrie ENVIRONMENTAp L HEALT DEPARTMENT FILES [-n V . : V <br /> 4UNDERGROUND TANK (UST) CLEANUP SITE (LOP) EJ HOUSING ABATEMENT b SOLID WASTE FA01,17y <br /> OTHER CLEANUP SITE (NON-LAP) IM FOOD FACILITY Cl SOLID WASTE VEHICLE <br /> UNDERGROUND TANK (MONITORINOIREMOVALf ❑ DOG KENNEL Cl DAIRY <br /> �'( HAZARDOUS WASTE GENERATOR M CHICKEN RANCH O PKG TREATMENT PLANT <br /> C7 TIERED PERMITTED FACILITY M MUTELINOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> © TATTOOBODY PIERCING Cl POOLISPA 0 LAND USE APPLICATION SITES <br /> CJ MEDICAL WASTE FACILITY O OTHER (PLEASE SPECIFYL - <br /> 1 . List up to ten addresses in the space above, Select the type(s) of files from the list bo by checking <br /> the appropriate box(es), At least one file type MUST be selected, Fax to (209) 04"00138 or mail to the <br /> address indicated above, <br /> x, END will notify the applicant a any END files exist.. An appointment for review will be confirmed <br /> approximately five business days but no later than tan (f 0) days after receipt of application. The piles <br /> will he 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 END staff may not be immediately available for review: A new <br /> application may, be submitted when the file is available. <br /> 44 Any file not raturnod In the same condition as released will be reorganized . EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $9300 deposit prior to review <br /> 5. "TENTA'('IVE appointment dates must be confirmed with END Staffs <br /> 6., Applications received after 5:00 pm will be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE . FAX INTPALSI <br /> REVIf WED YES NO REVIEW PATE <br /> env uaauoe ' <br /> anrsaat <br />