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03/15/2004 15:06 2894571118 AGE STOCKTnN
<br /> PAGE 01/
<br /> DATE RECEIVED EHD LOG NUMBER
<br /> SAN.�OA.QUIN COUNTY •
<br /> tf Af_;:�1 ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 304 E Weber Aye 3rd Floor Stock-ton, CA 95205
<br /> 04 MAR 15Oq,�+obi-34.20 Fax: (209)464-0138 Web:www.co.san joaquin.ca.us/ehd
<br /> [ 4 PUBLIC
<br /> RECORDS RELEASE APPLICATION
<br /> APPLICANT: BUSINF_35►AGENCY:� C,'g.Enu 1 m' n M e, ,
<br /> ADDRESS 32 Shaux—LROaa ., STO ! (�
<br /> PHONE: innti lal 10-6 FACSIMILE: g e 1I
<br /> TENTATIVE*APPoINTarFNT DATE: 3 Tl,r,o: &YyAft or.
<br /> (Phase allow 10 busing%%days from dmU of application submittal)
<br /> CHECK BOX TO EXPEME REQU -$93.00 FEE—REQUEST PRO SSED 1 3 BUSINESS DAYS
<br /> SIGNATURE OF APPLICANT DATE 31s-109
<br /> Deparlmsrd UsG Only
<br /> FTL,l;ADDRESS UNrT
<br /> street 004 1fcarV
<br /> > f
<br /> 1
<br /> 3. street �l
<br /> A. street Unit 2 �W01
<br /> Unit 3
<br /> D. street p
<br /> 7- Eve* a
<br /> 4ef000unit 4
<br /> a sib« city
<br /> &. street
<br /> Unit 5
<br /> 10- street q
<br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES
<br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT 0 SOLID WASTE F W +
<br /> OTHER CLEANUP SITE.(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE
<br /> UNDERGROUND TANK(NIONITORINGlREMOVAL) ❑ DOG KENNEL ❑yAIRY
<br /> HAZARDOUS WASTE GENERATOR d CHrcKEN RANCH '; PK0 TREATMENT PLANT 1 CY] 1\
<br /> ❑ TIERED FERWTTED FACIUTY ❑ VOTEIJHOTEL LIMPER TRUCKIYARD1CHEM TOILETS
<br /> ❑ TATTOO/1300Y PIERCING POOL/SPA y�. b USE APPLICATION s
<br /> EEW1
<br /> ❑ MCAL WASTE FACILITY OTHER(PLEASF SPECIFY)�t DI1
<br /> �yy
<br /> List up to ten addresses In the space above. Select the type(-)of files from ffie I(st above by checking
<br /> the appropriate box(es). At least one file type MIDST be selected. Fax to 209 464-0138 or mall to the,
<br /> address indicated above.
<br /> 2. EHD will notify the applicant if 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 maxlmurn 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.
<br /> *TENTATIVE appointment dates must be confirmed with EHD staff.
<br /> 6. Applications received after 3:00 pm will be processed the next business day^
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