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08/09/200 TAU 5;05 FAX 201982999 SJC PUBLIC FORKS 2003/006 <br /> GAT! REC IVED EHQ I,OG NUMBER <br /> SAN JOAQUIN COUNTY <br /> El NVIRONMENTAL HEALTH DEPARTMFN-I' <br /> Qcli, `51 304 E Weber Ave 3`d Floor Stockton,CA 95205 <br /> 468-3420 Fax:(209)464-01.38 Web. www.co.san joaquin-ca.us/chd ✓ ` <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Claudia Gembcrli.ng BUSINESS/AGENCY- San Joaquin County Public Works Department <br /> ADDRESS: 1810 E. Hazelton Avenue, Stockton, California 95205 <br /> PHONE: 953-7624 FACSIMILE: 468-2999 <br /> TENTATIVE*APPOINTMENT DATE: Time. <br /> (please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93,00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Ly_g_aL(& ALL_"/ k DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> 1. s—t CFr <br /> z, s+reet 0 Unit 1 <br /> a_ see 6 <br /> a. Stroct 424/70 c't tir '-t 0� Unit 2 r <br /> 5. street aLy gp city � <br /> �hy' ` ` Unit 3 <br /> al ((( <br /> F. Stinc��4�� G <br /> 7. Ct <br /> ,S cit7U04 <br /> g. Smgot <br /> Cit <br /> ,o. Slmai 'z 7 flit rJ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ft <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY �4'OTHER CLEANUP SITE(NON-LOP) 173FOOD FACILITY SOLID WASTE VEHICLE w�� <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNELDAIRY <br /> ]5� <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH PKGTREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> TATTOOBODY PIERCING ❑ POOMPA d LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY la OTHER(PLEASE SPECIFY) <br /> 1. List up to ton addresses in the space above. Select the type($)of files from the list above by checking',, <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the <br /> address indicated above. <br /> 2, EHO 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 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 /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day. <br /> O I C i � APN�P- r _ SAT.' TIMI~ _ <br /> PATF.. RM i 9E: A <br /> ,E <br /> ztE1Xlplfi�/0 �" <br /> END4"24" .........,:....__.......,_..... __.,. ....-.................. <br /> U9f2002 <br />