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it,', 28/2004 13:24 FAX 209 94801# <br />DA* RECEIVED SAN JOAQUIN COUNTY <br />ENV1RONMNTALHEALTHDEPARTMMNT <br />304 E Weber -Ave 31' Floor Stockton, CA 95205 <br />(209) 469-3420 Fax: (209) 464-0138 Web: www.co.sm-joaqum-caus/ebd. <br />pUBLIC RF <br />,CO]RDS RELEASE APPLICATION <br />APPLICANT: BUSINESSIAGENGY. rl <br />ADDRESS: •Z4, <br />ONE; ZqjqcLZ <br />PH <br />TENTAT(W APPOINTMENT DATE: <br />Ath_q� <br />(please allow to business days from date of application sub(WrftQ <br />[a 003 <br />CHECK BOX M EVEDITE RFWEST - $93-00 FEE —REQUEST PROCESSED IN 3 BUSINF3S DAYS <br />SIGNATURE Of APPLICANT DATE <br />ENVIRONMENTAL HEALTH OF_pAKrMENT FILES <br />Unit 3 <br />�.,Oowl UnIt4 <br />0 Unit 5 <br />CLEANUP SM (LOP) 0 HOUSING ABATEMENT 4M SOLID WASTE FACILITY <br />Ot UNDERGROUND TAW (UST) 0 FOOD FACILITY C3 SOLID WASTE VEHICLE16 OTHER CLEANUP SITE (NON -LOP) <br />90 UNDERGROUND TANK(MONTI-ORINOMWOVAL) 0 DOG KENNEL 0DAIRY <br />in HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 11 PKG TREATMENT PLANT <br />r TO <br />0 MOTELOHOTEL .3 PUMPER TOILETS <br />* TIERED PERMITTED FACILI`TY [3 POOLISPA 61L LAND USE APPLICATION SMS <br />* TATTOOM00y PIERCING ®OTHER (PLEASE SPECIFY) <br />* MEDICAL WASTE FACILITY <br />i. List up to ten addresses In the space above. Select the type(s) Of files from the list above oy checking <br />the appropriate box(es). At least one file type MUST be selected. Fax to m2u8;4:9138 or mail to the <br />address indicated above_ <br />ist. An appointment for review will be confirmed <br />• <br />2. EHD will notify the applicint if any EHD files ex <br />approximately five business days but no later than ten (10) days after receipt of application. The files <br />willbe 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 now <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 />S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br />Applications received after 3:00 pm will be processed the next busl6ass day. <br />031WEIRM51)APPOINTM TE TIME <br />, <br />FNT-1DA <br />S <br />p06NE Nr(AL <br />YES <br />0 r D <br />FIRM D... <br />N <br />FAX' <br />1A .0 <br />R6�jWjElj 111��VIEW DATE .- <br />EMEW. <br />ME= <br />