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09/08/2004;7711:.41 ..2094671118 AGE STOCKTON _ _ -PAGE': � 01/0 . <br /> r�- EHD LOG NUMBER <br /> K <br /> ;,it 1 <br /> C�Ltt I/FID <br /> SAN JOAQiJTN COUNTY <br /> EN04 E Web ENTAL HEALTH DE,CA 95205 0010 <br /> SEP O $ 2004 304 E Weber Ave 3rd Floor Stockton,CA 95205 (w//1 <br /> ENVIROfJMENP X�209 468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.ca-uslehil <br /> PERMIVSERVICES�H PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:LVJZO <br /> g BU�SI�NE�S�9IIAGENNCY: L�IICCIJ Q IJII'M�lf�'fJ & <br /> ADDRESS•..•7� -. 7 1S�yQf <br /> PHONE: K07" G/'IQQ FACSIMILE: ^� �IAAAA(( Ila <br /> 04 <br /> TENTATIVE"APPOINTMENT DATE: • P 9 OTime: <br /> (Please allow 10 husinew days from date of application submltt !) ftaI JV <br /> CHECKaOXTOEXPEDrTEREQUE T•S9S.00 FEE—REQUEST CESSE IN 3 BUSINESS DAYS C� J~ ��Jl <br /> SIGNATURE OF APPLICANT DATE I O Gw/ <br /> Deparhnent Use Onty <br /> FILEADDRESS UNIT <br /> ❑ Unit 1 <br /> do zs 9. o p <br /> s. seex Unita <br /> 6 ow <br /> CN A416 <br /> 7, GanaI:pkUn <br /> o s�� CRY ❑ Unit 5 <br /> io. s,mel cx. <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FA <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) In DOG KENNEL ❑ DAIRY <br /> 555777 HAZARDOUS WASTE GENERATOR ❑ CHICKEN WINCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOMODY PIERCING ❑ POOUSPA O LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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 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 new <br /> application may he 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$93.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day. x - <br /> COI+IFh�M�Di4PPO1NTMEN$.DATE . •. -::: . : : :TfINE '._ . : : .:, <br /> UATi=tQNFMMET) <br /> a:.."r.?NONE. i? .>:• FAX iNFTIALS; <br /> AYE <br /> '•�IEki�6�1,IF_o� <br /> allieea <br />