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Nov 17 04 05: 11p Hang --r Inc <br /> 530 3 1490 p, 1 <br /> \ V <br /> [Q� f 1 wJ , EHU LOG NUMBER <br /> ✓_..., SAN JOAQUIN COUNTY <br /> NOV 17 2004 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton,CA 952052--, ( 3 ? <br /> FNVIRONMENT �g_3420 Fax:(209)464-0138 Web:www.co.san joaquin.ca us/ehd <br /> PERMIT/SERVI, <br /> PUBLIC RECORDS RELEASE/APPLICATION <br /> APPLICANT: BU51NE5S1AGENCY: /T Oy <br /> ADDRESS:: — C7 <br /> PHONE <br /> TENTATIVE'ApPotWMENT DATE: <br /> r1 (Please allow 10 bwLmai days from date of application submttW) <br /> u CHECK BOX TO EXPEoM REQUEST_$9 EE STP SED SWESS GAYS <br /> SIGNATURE OF APPLICANT OATS <br /> Department Use Only <br /> t>f+rr <br /> FILE ADDRESS L) <br /> I. _ p <br /> s Unit <br /> 13 � <br /> chy <br /> s- Unit 3 <br /> �„ <br /> U <br /> 6. Sv�el <br /> � D � nit 4 <br /> T. E►aet <br /> a <br /> s. sae. <br /> Unit 5 <br /> 10. st"t U 1 <br /> ENVIRONMENTAL HEALTH pEPARTMENT FILES <br /> 4ROUND TANK(u5T)CLEANUP SITE(LOP) O HOUSING ABATEMENT r3 SOLID WASTE FA nJTY <br /> SNK i�{OP) O FOOD FWUTY 0 SOUR WASTE VEHICLE <br /> OUND TANK(MOKITOWNGIREMO'VAL) 0 DOG KENNELQ DJKRY <br /> ILS WASTE GENERATOR M CHICKEN RANCH EI PKG TREATMENT PLWr <br /> ❑ TIERED PER WAs'11 U FA1CMER Et MOTELMOTEL D PUMPER TRUCKlYARD(CWM TOILETS <br /> 0 TATTOOMODY PIERCMG o POOLISPA l7 LA!!D USE APPLICATION SITES <br /> ❑ NI MICAL WASTE FACILITY 11 OTHER(PLEASE SPECIFY) <br /> I <br /> I. List up to ten addresses In the space above. Select the type($)of files from the list aboye t�y chocking <br /> the appropriate box(es). Al least one Tile type MUST be selected. Fax to(20g)464-4138 or mall to the <br /> address indicated above. <br /> ent for review will be confirmed <br /> 2. EHO will notify the applicant if any END files ex1sL An appointm <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 rye business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is activaiy being worked on by EHD staff may not be immediately available for review, Anew <br /> application may be submitted When the file is available. <br /> 4. Any file not returned In the sartw condltion as released will be reorganized by EHO staff at the expense '. <br /> of the app"lent. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 5, 'I•ENTATIVE appointment dates must be confirmed with EHD staff. <br /> E, Applications received after 3:00 pm whi be processed the next business day. <br /> T DE <br /> iCr?hiFIF MED 'R.P1!4X F- A1fTME °� I <br /> ° - <br /> fl�LTECQtJFjRM¢D. <br /> '-'P ONE <br /> FAX II�ITUS <br /> yIEWED NO REVIEW DATE. <br /> :. `fES <br /> i <br /> EMD N-02-0Oi <br /> TO 39dd H1-IV3H -JV-N3140,lIIW3 8£1009t, 0Z:91 170©ZILT/TT <br /> i <br />