Laserfiche WebLink
JUN-1Y-200b 16:19 CONDOR EARTH TECH 209 532 0773 P.02 <br /> Iv� Z$AN JVAYU11N %,UU1,4i Y <br /> U 13 1J <br /> AvMONWNTAL HEAL�'�bEPAIZMFNT <br /> 304 E Weber Ave P Floor Stockton, CA.95205 <br /> ?_OW9)468-3420 Fax: (209)454-0138 Web:www.co,san-joaquin.ca.us/ehd yZ0 <br /> kINVIRONIhEKT HEALTH PUBLIC RECORDS RELEASE APPLICAMN <br /> p � <br /> APPLICANT: r AZ E9 > e _c _BUSINESS/AGENCY,_ "XlWjZ_ GAr,_TH <br /> _ d <br /> ADDRESS: 0�1�G�3 •612J/362 LANE <br /> PHONE: 2.0,7 + J�3 0� •_4 i 1 —FACSIMILE;_ c�G1• �3 0�. �•��3 <br /> TENTATIVE'APPOINTMENT DATE: Time. 8 �� <br /> (Please allow 10 buslnaas days from A of application submittal) <br /> El CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> 1. so-eal 1 d �] Unit 1 <br /> 2. sveel 3 q 4 <br /> 3. Sucd l0 a `InL_ Tilt 2 <br /> a. Sdeee d 40 ./�KE - �" <br /> s. sv-m J� Vim.] F{ ve• CIN A �``F <br /> Unit 3 <br /> 7. S' 1 a unit4 <br /> B, Street l I 0 5 'a. �"" <br /> a. Sold r.,e W' L Chy Unit 5 <br /> 10- Sven 4 5. okto n , <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �e'r <br /> UNDERGROUND TANK(UST)CLEANUP SIT€(LOP) G HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL �f DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH ❑ PKG TREATM€NT PLANT <br /> L3 TIERED PERMWMD FACILITY L7 MOTEUHOTEL 17 PUMPER TRUCKIYARD/CHFM TOILETS <br /> ❑ TATTOOIRODY PIERCING 0 POOLISPA FC-LAND USE APPLICATION SITES <br /> Je- MEDICAL WASTE FACILITY Q 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(2091464.0138 or mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHO 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. 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 fife reviews by the same applicant may require a$93.00 deposit prior to-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 DATE TIME <br /> DATE CONFIRMED PHONE - FAX' INITIALS" <br /> REVIEWED YES NO REVIEW DATE <br /> EM U-02-006 <br /> e�arloas - <br /> TOTAL P.02 <br />