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\ , 10/13/2003, 12:33 9252836121 AEI CONSULTANTS F) DATE RECEWPO r; SAN JOA.QIU'IN COYTNT'St EN moNT1VitlENTAL HEALTH ]DEP,A RT1VT1✓NT OCT 1 3 2003 304E Weber Ave 3`1 Floor Stockton, CA 95205 - (209) 468-3420 Fax: (209) 464-0138 Web: w, vw.co.san-joaquin.ca.us/ehd :=Nvl1 "v;vl i� cALI H EICES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: _ IA13 D sf1i BUSINESS/AGENCY: RC 1 COI 6U -Ra( V5 PAGE 01 EHO LOG NUMBEF 1001 AA Oil ADDRESS: 'EQQQ �CAMInQ U1GCK 1c�ME. %l.J°'yot0LA � IrPQA_t kiyj`t Cl"i PHONE' �Z7��,� dD� •J FACSIMILE: -6 �1 7r TENTATIVE' APPOINTMENT DATE: l.,Jc-•i L.� (2 Time: 110LM' p T^— (Please allow 10 business days from date of application submittal) In CHECK BOX TO EXPEDITE REQUEST - $93 0 FEE - REQUEST PROCESSED 1N 3 BUSINESS DAYS SIGNATURE OF APPLICANT DATE t0 13 IV � Department Use Only ENVIRONMENTAL HEALTH DEPARTMENT FILES UNIT ❑ Unit 1 Pt 2 1 Unit (1 Unit 4 ❑ Unit 5 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY OTHER CLEANUP SITE (NON -LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE C] UNDERGROUND TANK (MONnoRiNG/Rl;MOVAL) ❑ DOG KENNEL ❑ DAIRY HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH CI PKG TREATMENT PLANT 149 ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS 0 TATTOO/BODY PIERCING ❑ POOLISPA o LAND USE APPLICATION SITES M MEDICAL WASTE FACILITY OTHER (PLEASE SPECIFY) -MQRDjln Sba[I- r� 1)l`' 1. List up to ten addresses in the space above. Select the type(s) of files from the list t above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (Z09) 464-0138 or mail to the address Indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. ' 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A nem application may be submitted when the file is available. 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to revieA 5. *TENTATIVE appointment dates must be confirmed with EHD staff. 6. Applications received after 3:00 gm will be processed the next business day. CONFIRMED AP!?®INTMENTDATE '1'iME DATE CONFIRMED -: ,:PH NE FAX _... INITiACs' -7777— REVIEWED YES NO REVIEW DATE EHD 48.02496 V8n003 WMIRTIMMMITE. ,', ` ENVIRONMENTAL HEALTH DEPARTMENT FILES UNIT ❑ Unit 1 Pt 2 1 Unit (1 Unit 4 ❑ Unit 5 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY OTHER CLEANUP SITE (NON -LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE C] UNDERGROUND TANK (MONnoRiNG/Rl;MOVAL) ❑ DOG KENNEL ❑ DAIRY HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH CI PKG TREATMENT PLANT 149 ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS 0 TATTOO/BODY PIERCING ❑ POOLISPA o LAND USE APPLICATION SITES M MEDICAL WASTE FACILITY OTHER (PLEASE SPECIFY) -MQRDjln Sba[I- r� 1)l`' 1. List up to ten addresses in the space above. Select the type(s) of files from the list t above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (Z09) 464-0138 or mail to the address Indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. ' 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A nem application may be submitted when the file is available. 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to revieA 5. *TENTATIVE appointment dates must be confirmed with EHD staff. 6. Applications received after 3:00 gm will be processed the next business day. CONFIRMED AP!?®INTMENTDATE '1'iME DATE CONFIRMED -: ,:PH NE FAX _... INITiACs' -7777— REVIEWED YES NO REVIEW DATE EHD 48.02496 V8n003