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-- ­ ­ ­U, 1 c:37 5.1E76/66005 <br /> STRATUS NO CALIF <br /> PAGE 01/01 <br /> 05/11/2004 14:50 4640138 ENVIRONMENTAL HEAL.- mut ul <br /> �v tl•IV LVID NUIVIOCK <br /> DATE MCSIVEL)_ 1'r'I�,n� ►.7/�N JOAQUIN C OUNT Y <br /> ES NnRONMENT,AL HEALTH DEPARTMENT <br /> $ 304 E Weber Ave P floor Stockton,CA 95205 <br /> APR (24�) -3420 Fax: (209) 464-0138 Web:www-co.san jvaquin.ca.us/ehd 115461 <br /> Et��ifi J?v[+�Ei IT HE-A TH <br /> ru ,i!T Sp-RV1rT—UBLIC RECORDS RELEASE APPLICATION <br /> TION <br /> APP I IGWT:�0 D 1�1 � - -- SWIN SWAGENCY:S� S4,V;AA - <br /> ADDRESS:4 (Ar do P Dr. 4'550 �rf�Yter t P*IIc 9V �- <br /> HONE. �07(a��r'^r _FACSIMILE-. U'�4D 476015 <br /> TENTATIVE APPOINTMENT GATE: I TIme: $.OUarYl, <br /> (Please allow 10 business duysfrom date ofap9I1* ion s" — —ubmlOal)( <br /> CHECK pax To EXPEDITE REOUESST.$93.00�[FEE <br /> �-�REQUEST PROCESSED 1N 3 BUSINESS DAYS � <br /> SIGNATURE OF APPLICANT ✓���"L GATE '��� <br /> ' Department Use Only <br /> UNIT <br /> FILE ADDRESS <br /> i e oK�'- ❑ Unit I'39 _9a <br /> Unit 2 <br /> y. 9tr* <br /> i. SlrKl � <br /> e st t ct C] Unit 3 <br /> e. suet >(%.:j <br /> nit 4 <br /> 7. SrKat G <br /> sty G t] Unit 5 <br /> s. suxt -- _ <br /> G <br /> 16. $tteet <br /> ENVIRONmr=NTAL HEALTH DEPARTMENT FILES <br /> LrIY <br /> UNDERGROUND TANK(UST)4t-EANUP SITE(LOP) O HOUSING ASATEMENT 0 SOLID WASTE VEHICLE <br /> � FQflO FAG�LITY d SOLID WASTE VEHICLE <br /> O 'OTHER CLEANUP Sr[E(NON-LOP) In DOG KENNEL, 0 DAIRY' <br /> 10 UNDFAGROUND TANK(1MONITORING/REMOVAL,) fl GHiCiC1=N RANCH 0 PKIG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR M1:3 CHILI.JN RAN 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TIERED PERMITTED FACILITY M PQOI.ISPA Q LAND USE APPLICATIbN SITES <br /> 12 TATTAOBOCfY PIERCING C] OTHER(PLEASE SPECIFY? <br /> L1 MEDICAL WASTE pAClLiTY <br /> 11 List up to ten addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate bax(es). At least one file type MUST be selected. Fax t___°I?091 a64-0138 or mail to the <br /> address indioated a6c�►e, <br /> Z. EMD will notify <br /> five business days but no later than tam(O)danj if any EHD files exist- An ys after receipt of application.�.he files <br /> apprehe 9PPIiQa <br /> xlm y Appointments should be scheduled <br /> Will be held for a maximum of five business days far review. Appo <br /> accordingly. <br /> 3. A file that is actively being worked on by EHL►staff may not be Immedlataly av2lilable for review. Anew <br /> application may be submitted when thL%file is available• at the <br /> 3e reorganized by ASO <br /> re file review's by the sante appl canteleased wil)may require a$93.0 Hd posit prior to� <br /> �, Any file net returned +lew, <br /> of the applicant. Futu <br /> 5, *TENTATIVE appointment dates must be confirmed with EHO Staff• <br /> 6. Applications received after 3:00 pm will be processed the next business day <br /> TIME <br /> CONFIRMEP APPOIN'TI1 ENT DATE 1NITfAI <br /> DATE.CONFIRMED PHONE . FAX <br /> REVIEWED <br /> YES NO REVIEW DATE. <br /> soma" <br />