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���!°Y:---»0?• 16/2007 15:08 MAT COPE INC 4 12094640138 <br />07/16/2007 _15; 0,?;209 138 ENVIRONMENTAL . ALTH <br />SAN JOAQUI N COUNTY <br />0 <br />�r.�sZ:i��P1Gt�i <br />PAGE 01/61 <br />EIH0 LOG NUM GER <br />= i ENVY ONMENTAi, HEALTH DEpARTMEN'T <br />i co; <br />07 roo <br />600 East Main Street, Stockton, CA 95202 <br />Teae"bone. (209) 468-3420 Fax: (209)'4.64-0138 Web: ver iv.sjgo`.o600, <br />r�/ehd <br />pURLTr urCQpnS op v, A <br />rr SE _VV - XlxCa J_ 1"1 ^ �� <br />170 <br />AAPLiCANT: t3USINE991A0ENCY: <br />ADDRESS: <br />PHONE (1): 4d a - 6 70 O _ PHONE t2►: PACSiMILE: Orb -.3y5- 6 F <br />TENTATIVE' APPOINTMENT DATE; Time; <br />(PleaSe allow 10 business daye., frorn date of app(Iration 6Ubmittdl-'renteiNa only • must be confirmed) <br />i� CHECK BOX TO EXPEDITE REQUEST. gg5,gq F E (CAS OR CHECK ONLY) - REQUEST PROCESSED IN a DUVNESS DAYS <br />SiGNATURE OF APPLICANT DATE <br />Electronic Information: © List [] Map - Description: <br />-—FILE ADDRESS EHD USE ONLY <br />—. <br />Street t� Street Name <br />Oily aCl <br />UnEf 1 <br />e JTZ <br />i ✓I <br />■ <br />Speolfc Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />,f Nt] RGROUND TANK (UST) CLEANUP SITE (LOP) r Houssmp ABATEMENT M SOLID WASTE FACtLmN£NrG.E <br />Fac OTWIR CLEANUP SITE (NON -LOP) O FOOD FACILITY 13 WASTE TIRc <br />G�bN IEfZGROUNp TANK (MONITORING/RrtmOVAL) U 000 KENNEL C DAIRY <br />F$AZARDOUS WASYt MWERATDR O OHIGKeN RANCH Q WAsTewAT@A TREATMENT PLANT <br />"fEREoPrmmmmoFACILITY IWMOTWHOTEL 0 PJMPERTRUCKfYARDICHENTOILEYS <br />Q TArrvoiBoaY PtapClNc Ci Paot,/SPA F LAND USE APPL{CAmN SITES <br />MEDICU WAS'M FACIUTY C OTKR (PLEASE SPECIFY) <br />WELL AND SEPTIC PERrarr RECQRDg Arts AVAiLA91,17 FOR REvlew - MONDAY -FRIDAY 0.00 AM•S;DOPM • EKCWDWQ HOLIDAYS. <br />1. List up t4 ten addresses in the Spee® above. Select the type(s) Of files from the list above by Oecking the appropriate <br />box(es), At least one fila type MUST ba selected. Fax to (2091164-0138 ar mall-ta the address Ind(cged above. Address <br />ranges wilt not be accepted - for additional asslstanee withfile addresses, contact the FHD. Applications receiveef aft®r <br />3:00 pm will be procassad the next business day. <br />2. The EHD wit; notify the applicant if any EHD Ties exist. An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will be held far a maximum at five business days for review, Appointments <br />should be scheduled accordingly. <br />3. A file that is actively being worked on by EHO staff may not be Immediately available for review. A new application tnay be <br />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 of the applicant. <br />Future fide reviews 6ytha 153M6 applicant may requfre, a $95.00 deposit prior to review. <br />EHb USE ONLY <br />