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03/25/2004 17:49 415989gg34 ENVSF PAGE 03 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAR 2 6 2004 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENT 304 F Weber Ave 3'a door Stockton,CA 95205 <br /> PERMIT/SERV368-3420 Fax: (209)464-0138 Web: www.co.san joaquin.ca.us/ehd <br /> PUBLIC RECORDS RELEASE A�PJPJLICATION <br /> APPLICANT: n 6;t&4- BUSINE/SSIAGE CY:_ � `� 4V9 elf-7 <br /> ADDRESS: L- �i G72",cr (20 <br /> //� <br /> PHONE: l �/1 J/�"iu, 2 Oq—M J 3 FACSIMILE:" <br /> //,� ,{,/tn C 1I�.--�, '�'Zn ✓ <br /> TENTATIVE'APPOINTMENTDATe; <br /> (Please alloy 10 businoss days from date of application submittal) <br /> 17 CHECK BOX TO EXPEDITE REQUEST•$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OP APPLICANT ,� 7. apz, A, Ag6' DATE <br /> Department Use Only <br /> FILE ADDRESS UNIY <br /> so- et/ G Cl i a& 4/' C] Unit 1 <br /> z. ir c L 0 <br /> )e n4 ❑ Unit 2 <br /> s, , G <br /> y-S—of <br /> s 8lr G o? A22= Unit <br /> ZZ W Er DeG 35a ^. � - <br /> r� c d95S Il <br /> e itO c a ❑ Unit 5 <br /> fty <br /> / ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> AJ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) P HOUSING ABATEMENT ❑ soup WASTE FACILITY <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MUNI I OHINGIREMOVAL) O DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR 17 CHICKEN RANCH O PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL 0 PUMPER TRUCKrYARDICHEM TOILETS <br /> G TATTOOA300Y MERCINC O POOLISPA ❑ LAND USE APPI ICATInN SITES <br /> ❑ MEDICAL WASTE FACILITY D 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. 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, 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 expanse <br /> of the applicant Future file 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 /> EHD yaiaD6 <br /> Cllrllq! <br />