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10/21/2004 16:12 FAX 209 9480E _ 002 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY <br /> ENVZRQNMENTA.L HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`d Floor Stockton,CA 95205 <br /> (209) 468-3420 Faa: (209)464-0138 Web:WwW.co.san joaquin_ca.uslehd <br /> OCT 2 1 2004 <br /> PUBLIC RECORDS RELEASE APPLICATION Zo <br /> r' PuCAW: 6USINE55/AGENCY: 1' e&[ odcr <br /> ADDRESS: 1M.�*�(e, �-h�'�-`f- 57'zk�-, •�� Q�o�o�5' <br /> PHONE: FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: d� � l' <br /> �7 _U <br /> I VV n <br /> (Please allow 10 business days from date of appliratiorl submtttaf) !� V <br /> Q CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE--RF0.UEST PROCESSED IN 3 BUSINESS DAY <br /> S <br /> SIGNATURE OF APPLICANT _ �" DATE <br /> D_oartment Use Only <br /> FILE ADDRESS UNIr <br /> -Z ❑ Unit 1 0 <br /> 2. s U V� OCT0 V`t <br /> s G Unit 2 0" <br /> 4. SieafCKY <br /> A- <br /> S_ s".( Unit 3 <br /> CRY <br /> ��. <br /> Unit 4 <br /> �y •- s G [] fllt 5 <br /> 10. Sasx G <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT LFL souo wAsT>;FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY Ia SOLID WASTE VEHICLE0 <br /> UNDERGROUND TANK(MONUVRINGIREMOVA4) ❑ DOG KENNEL 16L DAIRY `rw f� <br /> I>il HAZARDOUS WASTE GENERATOR ❑ CHICKEN P-Maji 54-PKG TREATMErrr PLANT <br /> 4 TIERED PERMITTED FACILITY ❑ MOTELJHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOLLE�S <br /> O TAT-roomoOY PIERCING 13POOLISPA I$ LAND USE APPLICATION SITES <br /> C] 10!!/l�L <br /> MEDICAL WASTE FAC1lITY ❑ OTHER(PLZASE SPECIFY) �t <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list aboye 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 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 ney <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 expens( <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to reviev <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFaRMED ApPOINTMENT'DA7E` TIME k, h _:' .5'• <br /> ?DATE CONFIRMECI h"`'i.k'f PHONE FAX-':: <br /> REVi.E1NED YES NO REVIEW DATE' <br /> EHO I8-02-006 <br /> uarzao� - - <br />