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OG/22/2004 11:59 30376: 9 TECHLAW INC PAGE 02/0 <br /> EHD LOG NUMBER <br /> DAT yEo-� SAN JOAQUIN COUNTY <br /> LL EWIRONMENTAL HEALTH DF,PAP-TMFNT <br /> JUN 2 2 2004 304 E Weber Ave 3'd Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209) 464-0138 Web: yAvw.co.,-,an-joaqvin.ca,us/ehd <br /> ENVIRONMENT HLALI H <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �n1�G @'� BU9INESWAGENCY:_L P� L2 1/1� <br /> D <br /> ADDRESS:,- 51 <br /> � H 0�__. <br /> PHONE: FACSIMILE: (_6Q 7 ~—=-�— <br /> TENTATTVEa APPOINTMENT DATE: T7me" <br /> (please allow 1D bO iness days Tran date of apPlleatlOn sulHnN1e1) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE <br /> '-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF h - <br /> APPLICANT � DATEZtU <br /> Department Use OnIY <br /> FILE ADDRESS ISS i - UNIT <br /> Unit 1 <br /> 2 „ X535 5 . Li " <br /> a so-ae, SD Si -I'• <br /> Unit 2 <br /> C 400e <br /> s so-ee $(0 5- L'n <br /> � 9. Li nit <br /> ,. 8� D <br /> e 9bem I p 0 1.61 ✓ 1\1\l\^\yup' <br /> J V <br /> s, soeeiq9D U Y <br /> to, sva� C" <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ` 2Q�4 <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 17 HOUSINGABATEMENT p SOLID WASTE VEHICLE U� <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) O DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> q TIERED PERMITTED FACILITY 0 MOTELfHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TIERED PERMITTED <br /> PIERCING 13 PooUSPA O LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY ❑ 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(2091 4640138 or mail o the <br /> address indicated above. appointment for review will be confirmed <br /> 2. EHD will notify the applicant if any EHD files exist An app <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 being 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 game applicant may require a$93.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> s. 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 /> e,ro u.ax.aaa <br /> wsov� <br />