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FSM Geo-Phase Environment Inc. FAX NO. 2095690295 Jun. 01 2004 10:02AM P2 <br /> EI, �p-,1 EHD LOG NUMB^ <br /> � `IS� SAN JOAQUYN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM-ENT <br /> .JUN 0 1 2004 304 E Weber Ave 3T Floor Stockton,CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.ca.us/ehd <br /> ENVIRON;E1 T HEHLI-H <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ye_ /' 0-V 4 BUSINESSIAGENCY:_S1�4 ���f� 4./�!!//r0 z7-*y e_'st <br /> ADDRESS: 7 44 a e,%-s anj Ale. 0-ef dog YC� �TOG�crf� <br /> r <br /> PHONE: J % �/�`! FACSIMILE: 5rfi <br /> 0� <br /> TENTATIVE"APPOINTMENT DATE: ^ <br /> (Please allow 10 business days from date of application submittal) <br /> �#i ECK BOX TO EXPEDITE REQUEST-$93-00 FEE—REQUEST PROCESSED IN 3 BU ESS DAYS <br /> G <br /> SIGNATURE OF APPLICANT DATE / <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> L G Unit 1 <br /> 2. s«st 23d ae Lo375(�_7 } <br /> a. sUat G' J, 3!6-4(Unit 2 <br /> 4. Swcct G <br /> 5. $Deet aly , <br /> ❑ Unit 3 <br /> e. Street aty <br /> r. strut City Unit 4 <br /> e. StrcctCKY <br /> e. street G Unit 5 <br /> 10. street Chy <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES � J <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑ SOLID WASRA4�_ <br /> `�3.;� <br /> ;COTHER CLEANUP SITE(NON-LOP) A FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> M UNDERGROUND TANK(MONITORING/REMOVAL) O DOG KENNEL 0 DAIRY <br /> 0 HAXARDOUS WASTE GFNFPATOR O CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTEL/HOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> O TATTOOIBODY PIERCING E3 POOL/SPA Cl LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY ❑ 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 expense <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 /> 0048-02-000 <br /> AMsr2003 <br />