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\j <br /> 10/13/2003 12 33 9252831'?.1 _ AEI CONSULTANTS F) PAGE 01 <br /> DATE,RECfEIVED EHD LOG NUMeEF <br /> -1 t i ._ ' SALT JO.A,QUIN COUNTY <br /> ��-1)I� '• -rpt <br /> ENVMONMNTA.L H EA,LTu Dirt PARTMLNT <br /> 0 C T 1 3 2003 304 E Weber Ave P Floor Stockton, CA 95205 <br /> NVII I. <br /> (209)468-3420 Fax: (209)464-01.38 Web: www.co.san-joaquin.ca.us/chd <br /> LI`4 1,-i1L]i" <br /> E'L flail"i PUBLIC RECORDS RELEASE "PLICATION <br /> APPLICANT: Sm BUSINESS/AGENCY: RE l (pr)5(,Ra 6 <br /> ADDRESS: �JOO Cxy\im D t' btn <br /> l y 2-0 �a((��/l n ut Cf a k,S e `1f A I <br /> PHONE: ��� �` 3-�,c�•dD� �Xj 11 FACSIMILE: __t / 6 7 � U1 7r� <br /> TENTATIVE"APPOINTMENT DATE: CO- L1 r �10 b 20 Time: <br /> r <br /> (Please allow 10 business days from date of application submittal) 4 <br /> CHECK BOX TO EXPEDITE REQUEST-$93 0 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE �0 C3 O� <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> ,. saver o Z. i^ ct ❑ Unit 1 <br /> 2. Weet G <br /> stra6c 0 5 � " a <br /> k street SO d 11 <br /> 5, street 7- ' Unit ( � <br /> s• st:<a S a <br /> UUM 66M <br /> z. street Gy j Unit 4 <br /> 8. Street q2ty OCT 21 <br /> 9. Street city ❑ Unit 5 <br /> 10, street <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT A SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) n FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> O UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 10 MOT'EUHOTEL ❑ PUMPER TRUCK(YARD/CHEM TOILETS %V <br /> 0 TATTOOIBODY PIERCING ❑ POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) _-jQQ Ojbl—: Cp& Armj ,DA <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above ay checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209)464.0938 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 EHp staff may not be immediately available for review. A nem <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 revie%% <br /> S. `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 /> CQNFIRMED Aep®iNTMENT.®ATE' - TIME <br /> DATE CONFIRMED `PHONE FAX: :"IN1TiALs <br /> REVIEWED YES NO REVIEW DATE <br /> EMD 48-02-M <br /> MM3 <br />