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0y/08/2004'. 11:41 " z2094671118 AGE STOCKTON {.• PAGE. 01/0 . , <br /> EIVplo ii 1l;1li=� EHD LOG NUMBER <br /> ��, i i y ID) SAN JOAQUIN C004TY <br /> SEP 0 $ 2004 304 $ Weber Ave 3`d Floor Stockton, CA 9520 <br /> ENVIRONME7VT (209 468-3420 Fax: (209)464-0138 Web:www.co.san joaquin ca.us/ehd <br /> PERMIT/SERV CESEAL�N PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BVSINESSIAGENCY: lAi2?Ly&blIM � i <br /> ADDRESS:. S11) OQ r Ck/ENt JW9sais~ <br /> PHONE: 209- <br /> FACSISIMILE: f/ <br /> 9 — M� /cP <br /> TENTATIVE"APPOINTMENT DATE: • Do- J5 <br /> (Pisses allow 70 businasa days from data of application submitli �jLL <br /> CHECK BOX TO EXPEDITE REQUE T•$9100 FEE—REQUEST CESSE IN S BUSINESS DAYS (� Q /� •�/'IlwWn•►',C' <br /> SIGNATURE OF APPLICANT DATE / Q <br /> Oeparhnenl Use Only <br /> FILE ADDRESS UNIT <br /> us` %�4 I <br /> ( z sues oZ d ❑ Unit, <br /> I Sim, <br /> ON <br /> —I� <br /> 4 6m«n ❑ Unit2 <br /> 3. StreeCRV <br /> Unit 3 <br /> 6 o-w q <br /> z fiawCny Un <br /> CRY <br /> D 61 em <br /> ❑ Unit 5 <br /> 10. 91rge1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST(CLEANUP SITE(LOP) 11 HOUSING ABATEMENT ❑ SOLID WASTE FA <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINCIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> RAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY El MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOA30DY PIERCING ❑ POOLISPA O LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to tan 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 immedla ly 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 /> 6, '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 /> b r: <br /> CONFIRMED APPOINTMENT.OATE:. ..: .:..::-. <br /> DATCONFIRME'D'.: .:P, 131V1=.:ia':i:; `:. :, .;, 'i: :'..: : ....... <br /> .....: .. .. : .:: ...H . .....; FAX.,... L.S._... . .� . ;.:. . .. <br /> gwexo.aaaaos .. ...- :. . ; ...-.. a .. ...... . . . ::... :. <br /> avmm <br />