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it <br /> 08/22/2003_ 15:19 2094- 54 FNSTTE ENVIRM PAGE 01 . <br /> rr14WjKUNnr_N i QL H TH PAGE 02 <br /> SAN JOAQUIN COUNTYPLISLIC HEALTH SERVICES 1114`l=I re <br /> ENVIRONMENTAL HEALTH DIVISION <br /> AUG 217 2003 304 EAST WEOUR AV> fqM THIRD F(.00R <br /> $TOCKTON CA 26202 <br /> J� , jI1 HENT HEALTH ("S)4U,'420 <br /> `1l`Ai1'!. RVICPq . PUBLIC RECORDS RELEASE AP <br /> PLiCATION <br /> APPLICANT <br /> 1.rJI 60� 'min YQd� uksUSIVESSrAGEItr <br /> A.00RESS 6105 `3 v,•�1 .I�'ltvC wS2U <br /> 4 <br /> PHONE, -7 Z `op w�FACstMILE <br /> TENTATIVE*Appowr mENT nArE Tme �. <br /> (Pltm"olve T le 10 b slneg,s dips m deep of apptlFatfon submumij <br /> CMECK BOX TO EXPED[TE REQUEST_353,00 FEE—AEQUE,ST PROCESSED IN 3 BUSINESS RAYS <br /> SIGNATUkE OF APPLICANT PATE Z7 Zo03 <br /> FILE ADDlZES$ THIS SIRE EHD STAFF V3E 0;L-Y' <br /> PROGRAM ELEMENTS SBARCN <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> J> UNUERGROUND TANK(USTj CLEANUP SITE(LOP) I7 HOUSING ABATEMENT M SOLID WASTE FACILMY <br /> 0 OTHER CL.EMUP SITE(wOH-LOP) D FOOD FACILI'T'Y D SOLID WAS'T'E VEHICIX <br /> UNDERr.AQUND TANK(Il ONITORINQ/1117 ROVAL) n UOG KENNEL ❑ 4NRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 4 PKG TREATMENT PLANT <br /> O TIERED PERMTTTF-0 FACtL[TY 0 MbTELhmoTEL D PUMPER TRVCWYARPiCHrrm TOI1.f;T5 + <br /> C7 TATTOO180t)Y PEIRCM0 n MOLISPA Cr t AND USE APPL.ICATIVN Sri's <br /> 0 MEDICAL WASTE FACILrrT ❑ PUBLIC WATER SYSTEM n OTHER(PLEASE SPLrCIFYABOVLT) <br /> 1. List up to tart addresses in the space above. Select the type($)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Eq to(2091 4fi1-0139 or frail to the <br /> AC101^035 indipated a 'eve. <br /> 2. E31p'wi11 notify the applicant if any'EHD files exist, An appointment for review will be confirmed <br /> approximately five business days but no later then 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 /> accoedin9ly. <br /> 3. A Fite`that is actively bring worked on by EMD Staff may nvt be immediately available for roView.'kA nese <br /> application may be submitted when the fila is available. <br /> 4, Any file not returned in the same condition as released will be reorganlzed by EHD staff at the expenim i <br /> of the applicant, Future file reviews by the same applicant may require a$89.00 deposit prior to review. <br /> 5. *TENTATIVE appaintMi?nt dates frust be confirmed vrith EHD staff. <br /> D- Appl"tions received after 3:00 pm will be processed the next business day. <br /> APPOIlvTMENT DATE- TTME _ <br /> DATE Ce3NFIRMED PHONE FAX ftUITEA[.S .. <br /> REVIEWED Yes NOtiEY1ELV DATE <br />