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Dec-10-04 14:35 From-TTI TETRA TF" 9t( INC +9168520307 T-568 P.01/01 F-945 <br /> SAN JOAQUINt�OUNTY I <br /> ENVIRONMENTAL.HEAD TH DEPART NT � 1 <br /> 30413 Weber Ave 3rd Floo Tock-ton, CA 952 5 v <br /> _ (209)46$-3420 Fax: (209)464-0138 Web: www.co-son loaq ca-us/ehd ' <br /> F 1 0 2004 PUBLIC RECORDS RELEASE APPLIC TION <br /> AP�y LN. JiE I✓ 1:n O J 1 U NW/AGENCY: nG Co <br /> ADDRFss�,t -; fJIgqV Kg I L L� S M TL J C Z <br /> PHONE: i:- IZI . �I� FACSIMItE: � I `���f21 '3 ... <br /> TENTATIVE`APPOINTMENT DATE: <br /> (Please allow 10 eusiness days from data of appllaauon 51,4 tial) <br /> ❑ CHECK Sox TO EXPEDITE REQUEST-;43.00 FEE>-REQUEST PROCESSED IN <br /> 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT PATE (0 <br /> Deportment Use Only <br /> FILE ADDRESS UNIT <br /> 0 <br /> �15T YfW y C 2C1-e C SIV•}� <br /> HiF z s� 52 Cn c Q Unit 1 <br /> N/ u? a bu.w t2A ST C(CU6 <br /> [] Unit <br /> "'4 Wj 212 t1 i t c e <br /> \� t-lyl s sem. 1p _ L s' c Unit 3 <br /> 23 V Clfvk ,�(�✓' <br /> )�v) ] S. iia C, it 4 G t1''� S7M CN 5 w <br /> ; 10 Sim. 3 r S- -L NUN C2 &TVC —Ott 3 ■ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 1 <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING AOATEMENT O Eq DOD WASTE FACILITY <br /> it OTHER CLEANUP SITE(NON-LOP) C3 FOOD FACILITY M 5PWD WASTE VEHICLE <br /> to UNDERGROUND TANK(MONITORINGIREMOVAL) n DOG KENNEL M tND <br /> RY <br /> �-HAZARDOUS WASTE GENERATOR n CHICKEN RANCH C3 TREATMENT PLANT <br /> Irl TIERED PERMITTED FACIUTY P MOTEwHOTEL 0PER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOBODY PIERCING t7 POOUSPA d USE APPLICATION SITES <br /> A MEDICAL WASTE FACILITY M OTHER(Pt.EASE SPECIFY) 1 .41 <br /> - <br /> 1. List up to ten addresses in the space above. Select the type(a)of NO 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 /> add�indir-ated 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 eceipt of application. The files <br /> will be held for a maximum of five business days for review. AppoinU ients should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHO staff may not be immed ately available for review. A ne <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorgar ized by EHD staff at the expens <br /> of the applicant. Future file reviews by the same applicant may requir a $93.00 deposit prior to revie <br /> S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next busine day. <br /> CONFIRMEP APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> RIEW! N1ED YES NO REVIEW DATE <br /> E n�ozaos <br /> iWr]mV� <br />