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06/22/2004 11.54 3037E`__'69 TECHLAW INC " PAGE 02/0 <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY -- I <br /> A,LTm.DEFARTMEN'1C.' <br /> ENVIRONMENTAL 1IE <br /> 304 E Weber Ave P Floor Stockton,CA 95205 <br /> .SUN 2 2 2004 + <br /> (209)468-3420 Fax- (209)464-0138 Web.www.co.san_joaquin.ca.us/ehd <br /> ENUkRONMiE[IT HL-ALTH <br /> PER AI'l/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPIJCANT: � <br /> 1',q A r1 C <br /> eAe BUsiNESSIAGENCY: <br /> ADDRESS: <br /> + PHONE: <br /> FACSVAIIILE <br /> it Tfine: <br /> TENTATIVE'APPOVNTMENT GATE: <br /> [Pleasa allow 10 business Jaya from date of appllcatlon 9ubmlt Q <br /> i � r <br /> e CHF_GK BOX TO EXPED"rTE REQUEST-$93.00 FEE—REQUE3T PROCESSED IN 3 BUSINESS DAYS <br /> � � `1 DATE Z2 U <br /> SIGNATURE 01=APPLICANT _ �p Department Use only <br /> UNIT <br /> FILE ADDR SS <br /> t. sane C �. ❑ Unit 1 <br /> p. sweet 5 3� S . it t e;%y <br /> a west <br /> SD S i '1. IF Unit 2 <br /> a stroet 0 U 7 �tC4�JJ\ <br /> i Unit 3to J <br /> i <br /> s. sweet1 0 0 C Unit 4 <br /> 7. slaw 3 9. L+ <br /> a. 8 . b 5 © Unit 5 <br /> s. saes+ U i <br /> cn <br /> vo, sreec �� <br /> ENVIRONMENTAL HEALTH DEPARTMENT TILES <br /> CLEANUP SITE{LOP) C3 HOUSING ABATEMENT p SOLID WASTE VEHICLE <br /> iJNDERGROUND TAMC(UST) <br /> �O'IRFR ❑ FOOD FACILITY CLW Up SITE(NON-LDP) KENNEL <br /> I C3 DAIRY <br /> UNDER0 ZOUN0 TANK(mQNITORINGMEMOVAL) a Dd KEN RANCH 0 PKG TREATMENT PLANT TOILETS <br /> CHI CKIYARD{CHEM TO <br /> HAZARDOUS WASTE GENERATOR a MOTEUH01 EL Il © PUMPER TRU <br /> ❑ TIERED PERMITTED FACILITY O OTELrHA �1 b LAND USE APPLICATION SITES, <br /> ❑ TATTODISODY PIERCING ❑ OTHER(PLIFYI <br /> EASE SPEC <br /> t 0 MEDICAL WASTE FACILITY <br /> 1. List up to toll 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 t4 209 4 40138 or mail o the <br /> dd ress' Ical,0 ove• lntment for review will pe confirmed <br /> 2. EHD will notify the applicant if any EHD files exist An app <br /> approximately five business days but no later than ten(10)d As oEntments should aftar receipt of application. <br /> ched ledff#� <br /> P business days for review. pp. <br /> five bush Y <br /> will be held for a maximum of fi � <br /> accordingly. <br /> 3. A file that is actively being warped on by EHD staff may not be itninedia#ely available for review. A new <br /> application may be submitted when the file is available._. be res aflized by END staff at the expense <br /> s released rg <br /> same Condition a o review. <br /> 4. Any file not returned in the S uire 1i$93.00 deposit prior t <br /> of the applicant. Future file, by the same appllCant;may reg s <br /> 5. *TENTATIVE appointment dates must be canflrmed with EfiD staff: <br /> 5. Applications received aft®r 3.00 pm will be processed the 1hext business day. <br /> CONF#KNIED APPOINTMENT DATE TIME <br /> DATE CONFIRMED <br /> PHONE 1FAX INITIALS <br /> RVVIEVIIEI] YES NO REVIEW DATE <br /> �sto�e-aa.aoe <br /> arermtrs <br />