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01/03/2001 11:08 20 14228 NEIL ANDERSC' -NVIRO PAGE 02/0 <br /> END LOG NUM[ <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> j FI�TEF� ENVIRONMENTAL HEALTIT DEPARTMENT <br /> 304 E Weber Ave 3'' Floor Stockton, CA 95205 <br /> N59) 4 8-3420 Fax: (209) 464-0138 Web=www•co.san-joaduin.ca.us/ehd <br /> b ---- PUBLIC RECORDS RELEASE APPLICATION = <br /> APPLICANT: <br /> yI) BUSINESSIAGENCY: <br /> f e <br /> ADDRESS: � �•- -�✓t�y, 5 <br /> PHONE: <br /> FACSfMILE: � <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal) <br /> El CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-RE ST PROCESSED IN 3 BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> Department Vse Only <br /> FILE ADDRESS UNIT <br /> Gty, Sp-��2'� p Unit 1 <br /> 1, SL•Ccl L ' +� CI <br /> ty <br /> Gy _— ❑ Unit 2 V <br /> 9. Street <br /> CI <br /> 4. 31rve1 <br /> G, Unit 3 <br /> Illy <br /> G, Sveet <br /> Cn Unit 4 <br /> 7. strril <br /> a. SIM <br /> G, ❑ Unit 5 <br /> 9. slre�l ' <br /> cl <br /> 10. $trrcl , <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(1157)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT C1 SOLID WASTE FACILITY <br /> ❑ SOLID WAS E VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY <br /> M DOG KENNEL ❑ DAIRY <br /> UNDERGROUND TANK(MONITORING/REMOVAL) Q CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR d MOTEUHOTEL ❑ PUMPER TRUCK/YARDlCHEM TOILE <br /> TIERED PERMITTED FACILITY 4 POOL/SPA <br /> LAND USE APPLICATION SITES <br /> TATTOOIBODY PIERCING p <br /> ❑ MEDICAL WA$TE FACILITY 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 check <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0938 or maltO 0 <br /> address indicated above. <br /> 2• EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approxi,-nately five business days but no later than ten (70) days after receipt of application. The fi€ <br /> tments should be scheduled <br /> will be held for a maximum of five business days for review_ Appoin <br /> accordingly, <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A v <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 expe <br /> of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to reg v• <br /> 6, *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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 48.02-COG , <br />