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vo/14/LUu4' 10:13 1'Ab ZU8 8430521 10UUZ <br /> �TE RECEIVED a u....,.�,.....,.,.,. <br /> n((��'' (( SAN JOAQUIN COUNTY <br /> W LS .L \���=,L'�� IRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`d Floor Stockton,CA 95205 <br /> JUN 14 20Q409)468-3420 Doc: (209)464-0138 Web:www.co.san joaquin.ca.us/chd <br /> ENVIRONMENT 11EALTH pUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY:--- /c !`L."LAI <br /> ADDRESS: ate a sr /% q <br /> PHONE: 3 FACSIMILE: aog_/ el �C <br /> TENTATIVE•APPOINTMENT DATE: <br /> (Phase allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST;-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE G 11F O <br /> Deparbm t Use Only <br /> FILE ADDRESS UNIT <br /> l 4< Unit 1 <br /> i. lee/ y <br /> 7. Sind a syv,64 »e4,v Ung 2 (rk�y <br /> 4. V~ o F' "t sive LD ` <br /> Cr- <br /> S. sweet oo i Ac o,! Unit 3 3d�) <br /> s. stele 11.2 S' Ave Lo <br /> T. sueee /60 My A) Unit 4 <br /> el (0 <br /> S. steel G LII v Q Unit 5 <br /> m. sroac <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ,•,a <br /> MMERMOUND TANK(UST)CLEANUP SITE O HOUSING ABATEMENT SOLID WASTE ARV: <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACRJIY OCSOLID WASTE VEHICLE <br /> J4 UIWERGROUND TANK(MONITORINGIREMOVAL) 0 DOO KENNEL 0 DAIRY <br /> �S HAZARDOUS WASTE GEMMTOR 0 CHICKEN RANCH O PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY O MOTELMOTEL O PUMPER TRUCKIYARDlCHEM TOILETS <br /> 13 TATTOOIBODY PIERCING 0 POOLISPA 0 LAND USE APPLICATION SITES <br /> i3 MEDICAL WASTE FACILITY O OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the <br /> address Indicated above. <br /> 2. EHO 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(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 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 /> 4. Any file not returned in the 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 /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> 0 ;TA1TIMEOM p- <br /> K. .'::t. ..�-P.�•.�:+ <br /> 'rr. .. > _..PHONE FAX''::' : ', : -•:.'aFILAL.S ' , .:;:x: :: . <br /> :(ZE ITYVEIJ �_, YES _'NO REVIEW DATE' <br /> Is#Zaoa <br /> 12 <br /> srsnooa <br />