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110/31/2003 11:49 9253715915 GEOCON - EAST BAY PAGE 02/0 <br /> -rTr:=_0ATE REOGNED ——•.. r1F4QC XJl <br /> cn u R,W mumacm <br /> SAN JOAQMN COUNTY <br /> ENVIRoNMEN TAL REALTH DEPARTr4ENT <br /> 304 E Weber Ave 3'4 Floor Stockton,CA 95205 <br /> C)C I (. M4 X3'420 Fax: (209)464,-0138 Webc www.co.satA ja.0 <br /> oaquuLCs/ebd <br /> :ITBLIC RIECORDS RELEASE <br /> APPLICANT: /- n <br /> � USINESSIAGeNCY: ' <br /> =)RESS- 7g, AA .L G' <br /> PHONES <br /> TENTATnrE*APPOINTMENT DATE: Tom: <br /> (Plua9e 4I1ow 10 hualnesR days from dab of application submittal) <br /> 13 CHECK BOX To 1w ODM REQUEST-$93.00 FEE-YQUEST P C 10 811"INESs DAYS <br /> SIGNATURE OF APPLICANT DATA <br /> Department Use Only <br /> FILE AD REBa UNIT <br /> N°2 , OC N° Unit 1 �.rl <br /> a. s G ' .f p C 3 5 e El Unit 236. CW <br /> G <br /> 6 rc C GO <br /> J1 .i lnit 4 <br /> a reel0 0 e A ;Avc D <br /> s,.gn o Cg ML_ E3 Unit 5 <br /> o. ZZ7Z. f <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q 14OUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> "A OTHER CLEANUP SITE(NON-LOP) 0 ROOD FACILITY CJ SOLID WASTE VEHICLH <br /> C7 UNDERGROUND TANK(MONITORINGMEMOVAL) ❑ POG KENNEL 0 DAIKY <br /> ❑ HAZARDOUS WASTE GIENERATOR O CHICKEN RANCH C7 PKG TRFATMEN7 PLANT <br /> O TIMD PERMITTED FACILITY C MOTaMOTEL LI PUMPER TRUCK/YARDICHEM TORN$ <br /> 0 TATTO0111IODY PIR90ING D PGOtISPA 0 LAND USE APPLICATION OTMS <br /> O MEDICAL WASTE FA00JTY 0 OTHER(PLEASE SPI=CrIeY) _ __ <br /> 1. List up to ten addresses in the t;pace 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=9)a64�2_1 or M1111 to the <br /> addass indicated a,2ve. <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 IatAr than ten(10)days after receipt of application. The fll" <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 flip is available. <br /> 4. Any file not returned in the same condition aaxeleasad viii be reorganized by)AHD staff at the expense, <br /> of the applicant. Future file reviews by the same applictsnt may require a$93,00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates mpst be confirmed with EHD staff. <br /> a., Applications received after 3;00 pm will be procasaed thA next business Olay. <br /> CONFIRMED APPQINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO haVIEW DATE <br /> 4MD ia• ' <br /> 03 <br />