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FROM : ENGEO INC TRACY, CA FAX NO. : 209-835-0675 �:t. 31 2003 11:55PI <br /> EHD LO NUMBE <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> 1 <br /> P;NY[T20Niv1EN7'AL T-IEALTH DEPARTMENT <br /> 304E Weber Ave 3`d Floor Stockton,CA 95205 <br /> OCT 3 1 ZN9) 468-3420 Fax: (209) 464-0138 Web:wvrw.co.sanyoaquin.ca.us/eiid <br /> LiH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ASE'�L-FE SE.rL4& __BUSINESSIAGENCY: <br /> ADDRESS: 2$190 <br /> PHONE: 209- $3'6-6610 FACSIMILE: 209-$35 -067b __ <br /> TENTATIVE'APPOINTMENT DATE: 41-ypTime: <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 0 BUSINESS DAYS <br /> -* <br /> SIGNATURE OF APPLICANT — DATE oI' <br /> /5 Department List Only <br /> FILE ADDRESS UNIT <br /> WV / <br /> Lop o" [ �- Uni 1 <br /> AO A 7 C 7N <br /> osf r ue c. AUy e a 1 Uni 2 '.. 11,1.��'13 <br /> A. e'h ��'�--��CC <br /> 0 / r- _� Gh Lf.J7FP a O S \ (/ <br /> r. su«t NA o cn 1 Uni <br /> s. sveet l AIROoT WAY AO A/ 44 <br /> 7 <br /> e. sveet G '7 &jAy Uri! 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 2d HOUSING ABATEMENT SOLID WASTE t <br /> OTHER CLEANUP SITE(NON-LOP) ,�S FOOD FACILITY9 I,SOLID WASTE HI L�u�"3" ys FI <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR ( CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELMOTEL 0 PUMPER TRUCKrYARDICHEM OILETS <br /> ❑ TATTOOlBOOY PIERCING ❑ POOUSPA )d LAND USE APPLICATION sfTE <br /> MEDICAL WASTE FACILITY )d OTHER(PLEASE SPECIFY) U[✓f/N6 p /^ O <br /> 4-'t <br /> List up to ten addresses in the space above. Select the type(s) of files from the list above by c hacking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mai 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(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- Anew <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 I o review. <br /> 5. '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 PATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHe t3-0$406 ' <br /> wersom <br />