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08/09/2007 HU 15:05 FAX 209W2999 SJC PUBLIC WORKS X004/006 <br /> DATE RFCEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DFPARTM)h <br /> 304 E Weber Ave 3`d Floor Stockton,CA 95205 <br /> J(209)468-3420 Fax:(209)464-0138 Web; www.co-san joaquin.c:t.us/ i <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPucArrr: Claudia Gcmbexling 6usINESS/AGENCY: San Joaquin County Public Works Department <br /> ADDRESS: 1.810 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 /> rt <br /> 0 CHECK sox TO EXPEDITE REQUES1J�-$993.�.0.�0 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT C�-M� / DATE <br /> Dcpanmonl Uso Only <br /> FILE ADDRESS UNIT j 2. s, , f'o. .� p-3. © Unit I <br /> s a` f7� Unit 2 <br /> a. so-cct D T <br /> 5. Sheet Q al <br /> G. stmt City Unit 3 <br /> 7. strobt e',Z � <br /> 8. trout <br /> a` <br /> SUnit 4 <br /> e. sheet 2p p_ city ❑ Unit 5 <br /> to. st��, 6Y O ir <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �Q <br /> �C UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACT <br /> OTHER CLEANUP Sire;(NON-LOP) Q FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL, DAIRY <br /> JW HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHOTEL, PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOOIBOOY PIERCING ❑ POOLISPA Q LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY Q OTHER(PLEASE SPEciFy) <br /> 1. List up to ten 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 field 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 neral <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 fele reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 3. `'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 /> ....INT I✓ ,,,...._,,..,........ .. <br /> DATE:�At�IFIRMED <br /> Alf .;tl'[ITlAt� <br />