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11/26/2003 11:32 916-786-0366 LFR PAGE 02/E <br /> 01RAX 1 J UAY UJ N l-UY <br /> IN c ;, �: (I; E+NVMOIVN.l;�NTAL EALTHWrARTMINT <br /> 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> (209 468.3420 Fax: (209)464.0138 Web:www.co.sanjoaquin.ca.us/ehd <br /> N O V 2 2003 15 1 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: +�'�STiZ4�-r' BUSINESSIAGENC'Y: <br /> =E: <br /> -5,fry7-1 'Ei�' Cie 5?1K K - 7 e 6 - 7 369 FACSIMILE: 9/,�; - 7 8,6 — O 3 65 <br /> TENTATW APPOINTMENT DATE: Tlme: <br /> (Plaase allow 10 burnness days ff' m date of uppliCallon subtnittM <br /> Q CHECK BOX TO EXPEDITE REQUEST.393.d0 FEE-RE /ROC IN 3 BUSiNESS DAYS , 'L <br /> IGNATURE OF APPLICANT - DATE <br /> Department Use Or <br /> RLE ADDRESS UNrr <br /> �. Street cry 5 <br /> Unit 1 <br /> 7P�N���. s~-r�crt Yx�� (] <br /> 2. suaet 47J� 7F 7P7 C� <br /> s. str.d <br /> aly ❑ Unit 2 <br /> 4 � <br /> S, such U <br /> a- to <br /> 7. SIr"I Unit 4 <br /> a, snit a <br /> 9. <br /> cry flit rJ <br /> �e. strut CnV <br /> ENVIRONMENTAL HEALTH t)EPARTMENT FILES <br /> UNDERGROUND TANK(U37)CLEANUP$17M(LOP) ❑ HOUSING A13ATEMEW ❑ SOUP WASTE FACILITY <br /> -PL OTHER CLEANUP STM(NON-LOP) 13 FOOD FACILMY C7 SOLID WASTE VHHiCLIE <br /> 16C UNDERGFWUND TANK(MONITORiNGfREMOVAL) ❑ DOG KENNEL Cl DAIRY <br /> D HAZARDOUS WASTE GPNEWOR O CHICKEN RANCH O PKG TREATMefT PLANT ' <br /> GI TIERED PERMITTED FACILITY 0 MOTEWHOrTEL C1 PI.IMPER TRUCKIYARDICHEM TOILI <br /> CO3 TATTOOIBODY PIERCING D POOLISPA ❑ LAND USE APPLICATION saes <br /> D MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of fifes from the list above by Ched g <br /> the appropriate box(es). At feast one file type MUST be selected. "FaF,to (209)464-0438 or mail to t <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 tent (10) days aftor recelpt of application. The fii <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. Afile that Is actively being worked on by EHD staff may not be immediately available for review. A N <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 expo e <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to M rv. <br /> 5. `TENTATIVE appointment dates to Ust be confirmed with F-HD staff. <br /> 6. Applications received after 3:00 prn will be processed the next business day. • . <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED FAX. INFrIAL.S <br /> REVIEWED YiES NO REVII=VY DATE <br /> Et�D 4E-U�.U06 <br /> E�Er2t70J <br />