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09/15/2005 10:53 5306705 STRATUS NO CAL' PAGE 01/01 <br /> ENVIRONMENTAL HEALTH PACS 01 <br /> 05/11/2004 14:50 4640138 bMVLUU NUMOcn <br /> SAN JOAQUjN COUNTY <br /> � I ENVTRONMEIVTAL MALTTI DEPARTMENT <br /> Sty' 1 <br /> 5 2005 344 E Weber Ave 3`d noor Stockton., CA 95205 as us/ehd qVy <br /> EfVViROP,ti'',r_N� HEALTH (249) 448-3420 Fax: (249)464-0138 Web:www.cosan-joagtiin <br /> PERi�T,TiSE�VICES PUBLIC RECORDS RELEASE APPLICATION <br /> fes, <br /> �i guslNFssrnGENCY.�� s �n v�ro <br /> pPPuca IT: <br /> ADDRESS: 3 N `' / •7, _ n/L7 —..-.------ <br /> �•�G_ � FAC5IMLLE:_�-- <br /> HONE: <br /> Time: <br /> TENTATWE'APPOINTMENT DATE: application submittal)allow 16 bUsiness days from data of appl <br /> ❑ CHECK BOX TO EXpeoTre REQUEST-S93.00 FEE,REQUEST PROCESSED IN 3 BUSINESS DAYSDATE <br /> SIGNATURE OF OF APPLICANT D=Danment Use OnN <br /> UNIT <br /> FILE ADDRESS Q Unft1 �J <br /> D .30 dN / <br /> z, 61eeN O � Unit Z 1 ql <br /> .. <br /> nit 3 <br /> Oly <br /> s. awes C <br /> Unit d <br /> r. sr�n a <br /> [] Unit 5 <br /> e- o <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> ❑ SOUD WASTE FACILITY <br /> UNDERGROUND YANK(LIST)C,1-E/WUP 5n£(-OP) ❑ HOUSING ARATEMENT ❑ SOLW WASTE VEHICLE <br /> CJ FOOD rACtLl7Y ❑ DAIRY <br /> II OTHER CLEANUP SITE(NON-LOP) ❑ DOG KENNEL ❑ PKG TREATMENT PLANT <br /> ❑ UNDERGROUND YANK(MON ❑ Cl(ICKEN RANCH <br /> " F+ C� MO7E1-RtQTEL In PUMPESEAjCUCARDICHEMTaLLTS <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ LAND USE APPUCATION SnES <br /> ❑ TIERED PERMITTED FACILITY ❑ pop1SPA <br /> ❑ TATT00n3CVY PIERCING ❑ OTHER('LEASE SPECIFY) <br /> ❑ MEDICAL WASTE FPCILLTI s of files from the list above by checking <br /> 1 List up be selected. Fax to 209 464-0136 or mail tO the <br /> to ten addresses in the space above. Select the type <br /> the apprOPd�bax(es). At least One fl1e typo MUST <br /> address indiOat¢d above. appointment for rete of al bllcation. The files <br /> 2- END will notify the applicant it any END files exist An apps <br /> Appointments should be scheduled <br /> EHD will notify <br /> five business days but no later than tan(10)days after revel <br /> will be held for a maximum of five business days for review. APP° <br /> accordingly EHD staff may not be Immediately available for review. Anew <br /> 3. A file that is actively being Worthen the le is available. EHD staff at the expense <br /> application may be submitted when <br /> the same applicant May require a$93.00 deposit prior to review. <br /> � pny fife itot returned in the same condition as released will be reorganize Y <br /> of the applLcant. Future rite reviews by With EHD staff. . <br /> `TENTATNR appointment dates must be canPirmed <br /> 6 <br /> Applications receSved after 3:00 pm will be processed the <br /> next businoss rYay. <br /> TIME <br /> FREVIEWED <br /> D APPOINTMENT DATE PHONE FAX <br /> INITIALS ��— <br /> RMED REVIEW DATE <br /> YES N6 <br />