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12/28/2003 18:38 9252836121 AEI CONSULTANTS (SF) PAGE 01 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ( '<,� ENVIRONMENTAL D.EALxn DEPARTMENT <br /> 304 E Weber Ave 3d Floor Stockton, CA 95205 <br /> �E C <br /> 3 1. )468-3420 Fax (209)4640138 Web:www-cO.san-joaquin.c&us/ehd <br /> I <br /> s+:; v�"EPl i 1,L-Au PUBLIC RECORDS RELEASE APPLICATION Q2 <br /> APPLICANT: Yl `` BUSINLSSIAGErrN�,CY: ,r <br /> ADDRESS: <br /> PHONE: J FACSIMILE: <br /> Time: 1 M <br /> TENTATIVE.*APPOINTMENT DATE:_ + <br /> (Please allow 10 business days from date of app{icat7on submittal) �/Z <br /> 1 <br /> In <br /> CHECK BOX TO EXP£DVM REQUEST-$93.00 F E—REQUEST PROCESSED IN 3 BUSINESS DAYS 3� <br /> DATE <br /> SIGNATURE OF APPLICANT Department vie Only <br /> UNIT <br /> VgFILE ADDRESS <br /> C <br /> 2 .a Ss. s, 2 W 1 <br /> city <br /> Unit <br /> 'd Irl. a W <br /> W0. u Unit 3 <br /> 6 S1rcolt 1 G <br /> ty <br /> +� Unit 4 <br /> 7. sveet <br /> G [] Unit 5 <br /> ENVIRONMENTAL HEALTH DE=PARTMENT FILES �D <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ci HOUSING ABATEMENT M SOLID WASTE FACILITY <br /> SOLID WASTE VEHICLE <br /> M OTHER CLEANUP SITE:(NON-LOP) ❑ FOOD FACILITY <br /> IX UNDERGROUND TANK(MONfTORINGyIREMOVAL) O DOG KENNEL El DAIRY <br /> 13k HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 1k PKG TREATMENT PLANT <br /> B) TIERED PERMITTED FACILITY D MOTELIHOTEL ❑ PUMPER TRUCKlYARD/CHEM TOILETS <br /> TI E ED PE M PIERCING D POOLISPA 1K LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY O OTHER(PLEASE SPECK <br /> 1. List up to ten addresses in the space above. Select the type($)of files from the list above by checkinc <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 witl 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 ne <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 END staff at the expens <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to revie <br /> S. *TENTATIVE appointment dates must be confirmed with END staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> ' - 'IME <br /> CONFIRMED APPOINTMENT DATE . <br /> 'r <br /> DAT ' CONFIRMED ... "`PHONE FAX" INITIAtLs <br /> REVIEWED - : 'YES NO REVIEW DATE <br /> EHD 4842-006 `I . <br /> 8/8f280] - <br />