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09/29/20.04 12:'07 -FAX 209 4480 <br /> . ' CY1V WU.•v.,wv. <br /> DATE, EG>JVD, SAN JO.AQULN COQ <br /> r <br /> ENVMO.N•MENTAL] EALTH DFIPART11+ZNT <br /> 5 E P 2 9 2004 304 E Weber:Ave 314 Floor Stockton,CA 952.05 <br /> _ X209}4fi8-3420 Fax: (209)464-0138 Web:www.co.san joaquin.ea.uslehd <br /> ENVIRUNMEri f 1LA;.s i <br /> PEROT/SERVICES pUBL'IC RECORDS PXLEASE APPLICATION' '- <br /> k ApP1.IC1+lIT: 1 c.�. <br /> o5 M BUSINESSIAGENCY: Ih <br /> ADDREss: L+a C,4 fl <br /> PHONE- <br /> FACsiMIIE: t D�i''J�14 _060 - <br /> TENTATIW APPOINTMENT DATE: <br /> [Please allow 10 business days ftm data of application submittal} <br /> CHECK BOX TO I JCP>=PfT1=REQUEST-$93.04 FEE—REQUEST PROCESSED IN 3 6iJS1lIl=SS DAYS <br /> ,SIGNATURE OF APPLICANT _ '�-���'.� DATI- <br /> DeparMilt We Onix <br /> FILE ADOUSS rr <br /> ri-�, a r, r .- Unit 1 <br /> x sow a Unit 2 -� <br /> •• sbVd a <br /> GA �Unit 3 <br /> s sow <br /> r. svee� <br /> zti <br /> e. saran a Toil, <br /> 5a (P-ENVIRONMENTAL HEALTH DEPARTMF�FILMS 1 <br /> UNDERGROUND TANK(LIST)CLEANUP SITE(LOP) 0 HOUSING ABATF-MEHT BL sOUD WAST:FgCILfI"Y <br /> OTHER CLEANUP srm MON-LdP) ❑ FOOD>=AGILITY Q SollO WASTE VEHICLE <br /> >i UNDERGROUNDTANK{FiONITORINGIREMO1/AL) ❑ DOG KENNEL, ®-DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑ CIi1CKE1!RANCH PKG TREATMENT PLANT <br /> ❑ TIERED PERHIfrCED FACILITY ❑ MOTELJI40TF-L ❑ PUMPER TRUCKIYARI7lGHEMTOOTl <br /> E3 TIF-RETATTD <br /> MODY PIERCINGFCI 0 POOLISPA C• LAND USE APPLICATloN sny:s <br /> 0 MEDICAL WAST~FACILITY <br /> C3 OTHER(PLFASE SPE:CIFY7 <br /> 1, i_ist up to ten addresses in the space above. Select the types}of files from the fist above by checking <br /> { the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-01'38 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(1o)days after receipt of application. The files <br /> will be held for it maximum of five business days for review. pppointrnents should be scheduled <br /> —j acdordingly. . <br /> 3. A file that is actively tieing 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 /> i +t. Anyfile not returners In the <br /> 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 /> S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> t 8, Applicatioris received after 3;04 pm will be processed the next business day, <br /> �GONF�RM> D.`Al ff .1 -,-TIM <br /> 1?QINTl4IEN'CAl'E '� .r n;=::�• ..'• <br /> :: •.L_ i y. aTti r'. <br /> pAT� QKF11V1Q "�"::'`'rP1iON>r : FAX. <br /> R 1 7ED YES NO REVIEW DATE' <br /> • E}{o�6.px�as <br />