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----FROM : Geo-Phase Enyironmenta9c. FAX NO. 2095690295 . Jun. 24 2004 04:14PM P2 <br /> EGEI�LED EHD LOG NUMBERIL _ SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUN 2 4 2004 304 B Weber Ave 3r1 Floor Stockton, CA 95205 <br /> ((20911468-3420 Fax: (209)464-0138 Web:www.co,mn joaquin.Ca.uS1ehd <br /> ENVIRONIMEIW tiEAL1h <br /> PERFIIff/SERVICES PUBLIC RECORDS RELEASE APPLICATION [V <br /> APPLICANT:� (fPy. , � <br /> Z0, t4 BUSINESSIAGENCY: C ��OSB ,rJ{rjr0'+f ^ti t. M <br /> ADDRESS: �(�^-qq3/ M&V a -+ 9t-t Ayo <br /> % T/ �y �j <br /> PHONE: erA �3 FACSIMILE: 2 <br /> _ S�6/ dF 5� <br /> TENTATIVE'APPOINTMENT DATE: Time:_h/�. _ <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK 13OXTO EXPEDITE REQUEST.$93.00 FEE—REQUEST PROCESSED I BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS <br /> 1. sd✓ oZ c w r Unit 1 <br /> 2. Sv.tkest Y G 40 Ait — <br /> 3. At 2 <br /> d. Scree! 4 CI y♦ Ll� <br /> 5. eves <br /> Unit3 <br /> 6. S4eN CRY <br /> 7. sroc1 city �Unit <br /> e. Street Ci <br /> 9. sit c' p Unit 5 <br /> 10. SUM O' <br /> aft y re My IV 264Y <br /> PNVIRONMENTAL HEALTH DEPARTMENT FILES P� q <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY <br /> �THER CLEANUP SITE(NON-LOP) LJ FOOD FACILITY ❑ SOLID WASE VEHICLE,' <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY ll <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMn TED FACILITY ❑ MOTEL/HOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑ TATTOOIBODY PIERCING ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIF`t7 <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 EHO 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 filo 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 /> S. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business dar, j . <br /> CONFIRMED APPOINTMENT DATE TIME Y° <br /> DATE CONFIRMED PHONE FAX' INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 46-02-006 <br /> azYsow . <br />