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09/09/2004:;.1-09:14 . 925283E')l AEI CONSULTANTS (SF) PAGE 01 . <br /> D 17 E D <br /> EHD LOG NUM13Ef <br /> SAN.TOAQTJ,IN COUNTY <br /> ENvjRoNmmNTAL HEALTH DEPARTNXENT <br /> SEP 0 9 2004 304 E Weber Ave P Floor Stockton, CA 95205 <br /> (209)458-3420 Fax: (209)444-0138 W6;www_co.san joaquin ca us/ehd <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASEJT(APPLXCAnON <br /> APPLICANT• BUSINESS/AGENCY: <br /> nn5� lNrxlnvk C C 1 <br /> ADDRESS: o�- b ( Ind <br /> PHONE: arD ^ 5 aa) O FACSIMILE: 99,5 9�$-3 <br /> TENTATIVE*APPOINTMENT DATE: � Time: 1 1 <br /> (Please <br /> allow 10 business days ffrom]]]dobe of application submittal) I <br /> 6, ACHECK <br /> QUEST-S93.OD FEEQUST'P0OSa Ct11USSSBOX TO EXPEDITE <br /> SIGNATURE OF APPLICANT U DATE �t fl <br /> 4 Department Use Only <br /> FILE ADDRESS UNIT <br /> ,. sveel 3ct`c�. ASS c0.J1 � cI S ❑ Unit 1 <br /> a <br /> z. s�� 3(0 5�; E. G � k <br /> s, slml q tL S/A-q q Z ft5 a0153 J01 Unit 2 q y <br /> ✓✓ 4, $Irr9l n CI �` GIT 12 <br /> :LlQ '" l5 Wa N. a `� U Unit 3 <br /> 6. 9vaet <br /> 1LS11 <br /> a l T i aGt L <br /> V/,/ i <br /> r, sc <br /> 59lP N. w' a UST SCS Unit 4 <br /> e1 s� a <br /> 9. ly stm� a Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT �SOUD WASTF FAC <br /> �.OTHER CLEANUP srrE(NON-LOP) C3 FOOD FACILITY ❑ soup WASTE VEN E <br /> �& UNDERCROUND TANK(MONITORINGIRFMOVAL) L] DOG KENNEL O DAIRY <br /> HAZARDOUS WASTE GENERATOR a CHICKEN RANCH 0 PKG TREATmtHT PLANT <br /> TIERED PEtiMCCT1=D FACILfTY ❑ MOTELIHOTEL PUMPER TRUCKJYARDICHEM TOILETS <br /> O TATTOOIBODY PIIE:RCING ❑ POOLISPA LAND USE APPLICATION SITES <br /> iD MEDICAL WASTE 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 checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)46a-D138 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 held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. Afile that is actively being worked on by EHD staff may not be immediately available for review. A neH <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 /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED 40QINT TIME u::... <br /> P MENT DATE ;+Y , <br /> DATE CONFIRMED ::." PHONE:. .'FAX INIT.IACS' <br /> REVIEWED YES NO REVIEW DATE --- <br /> EMU ss-02ave <br /> ararzoos <br />