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DEC-13-2004 12:53 -9NDOR EARTH TECH 209 532 0773 P.01i0: <br /> OTE RECEIVED - EFFIp LOG NUN <br /> SAN JOAQUIN COQ <br /> E+NVMONIYIIi'TAL RF.AT.TH DF'rARTZVIE°NT <br /> DEC 1 ;3 2004 304 E Weber Ave 3`d Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209) 464-01.38 Web: www.co,sat-joaqum.ca-us/ehd <br /> i' <br /> ENViRuN1 V;i._N: r1 _, _ 1 <br /> R` !CES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: [-" t�S ( y[1AIZAL,g�X BUSINESSIAiGENCY: <br /> ADDRESS: T D /_V nib <br /> FHON '7 1L �- <br /> - �G FAGSIMllF:C-20�67 — Q !� <br /> TENTATIVE=APPOINTMENT DATE: I -DECem 6.r. lme: - <br /> (Please allow 10 buslnaas days from hate of appllcatlon submittal) <br /> CHECK SOX TO�rmrria I T-$93.00 FEE--REQUEST PROCESSED IN 3 BUStNE55 DAYS <br /> SIGNATURE;Op APPLICANT DATE <br /> Department Use Only <br /> FILE AbDRESS UNIT <br /> -i—,. 3rod4 AiKFo-,--raUcro Na [� Unit 1 <br /> 2- /Sht.0 <br /> t 9` strwor <br /> 3,15 T Unit 2 <br /> ,. amt - <br /> S. �` x ° Unit 3 <br /> g PE>vTd7ri= b a ` <br /> i + ons UTAHIKF'ela 0 sad Unit 4 <br /> �. N To vrN co IN's crorz —j-? W1 r Wy <br /> l0N u>~IC, F,ALLRDAD1 �63� G C�I;fi Sr o2 nits <br /> t r5S <br /> 1 <br /> ,o. curet car, �- <br /> ENVIRONMENTAL HEALTH QEPAkrrMENT tttFILES <br /> kf UNDEPGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING AaATEMENT SOLJD WASTE F . <br /> OTHER CLEANUP SITE(NON-LOP) b FOOD FACILITY SOLID WASTE <br /> UNDERGROUND TANK(MONITORINGfREMOVAL) 0 DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH t7 PKG TREATMENT PLAKT <br /> TIERED PERmrrTF_D FACILITY MOTELIHOTEL d PUMPER TRUCWYARDMHEM TOLETTS <br /> O TATTOOMOOY PIERCING 11 POOLISPA LAND USE APPUCAT10N SITES <br /> MEDICAL WASTE FACILITY ❑ OTHER(PLLASE SPECFr <br /> 7. List up to ten addresses in the spade above_ Select the type(s) of files from the list above�y che0drij <br /> the appropriate box(es). At least one file type MUST be selected. Sax to(209) 464-0138 or mail to the <br /> address Indicated above. <br /> 2. FHD will notify the applicant if any EHD files exist An appointment for review will be confirmed <br /> approxlmaWy 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 net <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned in the same condition=released will be reorganized by HHD staff at the expens <br /> of the applicant. Future file mviews by the same appll=nt may require a$93.00 deposit prior to ravier <br /> 5. 'TENTATIVE appointment dates must be confirmed with FHD staff. <br /> 6. Applic-atiorts received after 3:00 pm will be processed the next business day. � T <br /> CONFIRMED APPOINJTMl_NT PATI~ TIME <br /> DATE CONFIRMED 'PHONE FAX INITIALS` <br /> REVIEWED — YES NO REM EIV DATE <br /> TOTAL P.O: <br />