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_____P3/24/2004 10:35 FAX 209 94806;"1 @1002/002 <br /> T—.IVSD <br /> n, l i / I(--- SAN.JOA,QUIN COUNTY <br /> V <br /> ENVIRONMENTAL HEALTEI DEPARTMENT <br /> MAR 2 4 2004 304 E Weber Ave 3"d Floor Stockton,CA 95205 <br /> (�09)468-3420 Fax:(209)464-0138 Web:wwW.co.san joaquin,ca.us/ehd <br /> ENVIRONMENT I-EHL H /1/03 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICA-nON <br /> APPLICANT: OCl S X_&Al _ BUSINESSIAGENCY; A l elle <br /> PHONE: �' q4�g_ �/$r FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE.: 3 R r Ti <br /> i <br /> (Please allow 10 business days from,date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT /lyj� DATE 3 - <br /> Deparbnen Use <br /> Only 0 <br /> FILE ADDRESS UNIT <br /> lei JOO/i [� Unit 1 <br /> 44, <br /> i 'T k a If <br /> 3. + j 41 g!ooOtt <br /> — K)0-r ova Aa drb - 21 <br /> S. s 3 �i10 a �. <br /> unsf s <br /> 6. Ott <br /> 7. saee1 0 <br /> a• Unit 4 <br /> 9. 59x®1 My Unit S <br /> s <br /> VAR 26 2004 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(us-r)CL EmuP SITE(LOP) ❑ HOUSING A13ATEMENY W SOUR WAS1t FAGLIT 1 <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> Er UNDERGROUND TANK(MONITORINGIREMOVA L) ❑ DOG KENNEL l91 DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH JAS PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEL MOTEL E3 PUMPER TRUCK/YARD=CM TOILETS <br /> ❑ TATTOOIBODY PIERCING 0 POOUSPA )A LAND USE APPLiCATiON srTEs <br /> a MEDICAL WASTE FACILITY L] OTHER(PLEASE SPEC <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list aboye 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. EMD 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 immediately available for review. A new <br /> application may be submitted when the file is available, <br /> 4• Any file not retumed 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 de osit ri to 4,v <br /> vr• <br /> 5. *TENTATIVE appointment dates must be confirmed with END staff. <br /> '' <br /> 6, Applications received after 3:00 pm will be processed the next business day <br /> .G W I.RMED APP'OINTMENT'bATE•' TIME <br /> ��N <br /> DATE• AA FAX CdNFiRp,�ED <br /> "' PiIONE . •, 1AL- <br /> REVIEWED YES NO REVIEW PATEEHO 4"2406 <br /> ' <br /> IUM003 <br />