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H/02/2007 THU 16:51 FAX 2094999 SJC PUBLIC WORKS 2003/005 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> /I ENVIRONMENTAL HEALTH DEPARTMENT <br /> f 304 E Weber Ave 3`d Floor Stockton, CA 95205 / <br /> (209)468-3420 Fax: (209)464-0138 Web: www.co-san jo"=ca. d <br /> PUBLIC RECORDS RELEASE APPLICA N 6 <br /> APPLIGANr: Claudia Gemberling aUSINESSIAGENCY, San Joaquin County Public Works Department <br /> ADDRESS: 1510 E. Hazelton Avenue, Stockton, California 95205 <br /> PHONE, 953-7624 FACSIMILE: 468-2999 <br /> TENTATIVE'APPOINTMENT DATE: Tim:: <br /> (Please allow 10 business days from date of application submittal y <br /> ❑ CHECK aOXTO EXPEDITE REQUEST--$993.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS p <br /> SIGNATURE OF APPLICANT 6 d�c4X Cl ice' DATE d ` °2'�7 <br /> L/ Department Use Only 46 <br /> FILE ADDRESS UNIT <br /> Lo _ <br /> 7 ❑ Unit 1 <br /> 3 J TLL 11:(Pk- �, Unit 2 <br /> s. s�ai <br /> rl Sta4e Qaut�9 orTi'a '�' <br /> I bt ✓ okyr <br /> YL['Y r Unit 3 <br /> 6. 6eaa SD E � � L <br /> e. spm S DD <br /> sba 3 G l = (" p Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES V/ <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT SOLID WASTE F ILITY TTT <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH PKGTREATMENT PLANT <br /> TIERED PERMITTED FACILITY M MOTELMOTEL 0 PUMPERTRUCKr(ARO/CHBMTOILETS <br /> * TATTOOIBODY PIERCING ❑ P000SPA o LAND USE APPLICATION SITES .. <br /> O MEDICAL WASTE FACILITY 0 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)454AI38 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 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. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 5. Applications received after 3:00 pm will be processed the next business day. <br /> ¢ F - <br /> IRtdFI - q9 >A7C .INLTfALs <br /> ._:.:.M11�11f .,.,��_ .,....__. <br /> WO aUNW <br /> arermm <br />