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Jan 03 Os 10:03a Abert Nicholson s <br /> � -"714-3073 P- 2 <br /> ' DATE RECEIVED _ – - — — EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> EIVED ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3'Floor Stockton,CA 95205 <br /> .i&N 0 3 20@ 09) 8-3420 Fax:(209)464-0138 Web:www.co.san-joaquin-ca-us/ehd '5 <br /> ��I'___�-_� PUBLIC RECORDS RELEASE APPLICATION <br /> r...,_ �_ .. ..___..._,._.._.. .. <br /> APPLICANT:Bob Nicholson BUSINESSIAGENCY: RNC Environmental <br /> ADDRESS: 9746 Parkhm Way,Ek Grove CA 95624 <br /> PHONE: 916714-3073 FACSM JF- 916-290-0106 <br /> TENTATIVE"APPOtaTMENT DATE: Tkne <br /> (Phew allow 10 business days from date of application submittal) , <br /> CHECK BOX To EXPEDITE REQUEST-woo FEE–REQUF.STPROCESSED IN 3 BUSINESS DAYS <br /> DlgkW r siprod by Acben k Nld,dsw <br /> SIGNATURE OF APPLICANT °iW=&01MOWA4W-MW DATE <br /> Depertmset Use Only <br /> Fll.lg ADDRESS UNIT <br /> 1. 1720 East Pine cr, Lodi ❑ Unit 1 <br /> 2. sr.�1240 E Pine St q4, Lodi <br /> 213 South Kelly Street CRY Lodi Unit 2 <br /> 4. 9,,1220 Victor Rd gly Lodi 03S Lea ay.- <br /> 5. 32 N Cluff LodiUnit 3 <br /> e. sb.w 100 S Cluff Ave Lodi <br /> 7. -200&Bedtalen cft Lodi Unit 4 <br /> 902 Industrial Lodi /U•F <br /> a ❑ Unit 5 <br /> aly <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> FM UNDERGROUND TAMC(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT KA SOLID WASTE FACRITY <br /> OTHER CLEANUP SITE(NON-LOP) FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(iAOIREMOVAL) DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH PKO TRF.ATUMNT PLANT <br /> TIRED PERMITTED FACILITY MOTEL44DTEL PUMPER TRUCKJYARDICHEM TOILETS <br /> TATTOCIBODY POW NG POOLISPA 5 LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. Select the types)Of flies from the list above by decking <br /> the appropriate ba4es� At leahst one lila type MUST be selected. FaX to MP 464-0130 or mail t9 the <br /> address indiosteld abs n6ment for reviewvM be cor>f9rmed <br /> Z EHD will notl[y the applicant fl any EHD tiles exist An appoi <br /> approximately five business days but no later than ten(to)days after receipt of application. The flies <br /> win be held for a maximum of fine business days for review. Appointments should be scheduled <br /> accordingly <br /> 3. A file the is actltre{y bebhg worked on by EHD staff may not be imtnedhately available for review. Anew <br /> application may be submitted when the file is available. END staff at the expense <br /> 4. Any file not returned in the same corWWm as released will be reorganized by <br /> of the applicant. Future fife 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 /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> ehaoat4M <br /> err000s <br />