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OCT -15-2003 02:47 AN P.01 <br />1e11412UU3 12: 58 <br />ENVIRWIENTAL Hie PAGE E1 <br />\ DATE RECErvED bnU Lw nuM acn <br />\ , � SAN JOAQU[N COUNTY <br />VV E"RONMEn-kL HEALTB DEPARTMENT <br />OCT 1 4 2001 304 E Weber Ave 3rd Floor Stockton, CA 93205 � 2 <br />(209) 468.3420 Pax: (209) 464-0138 Web: www.w,s&n-joaquin.ca.us/dhd I J <br />PURLIC RECORDS RELEASE APPi.TrATTnrT <br />APPLICANT:,,(y4Y" III C �� �1� „R[�aU&alEaB1A0lNCY: <br />ADDRES3: � (�c�. ' ii�s ll ill I Cj .1 /7 Vl: <br />'nn• �LL PHONE: _ ccf •� OS i -cl I �1 _ FAGIMn[: C t(` oS - - / I I ,�r.�. <br />t' <br />TENTATIVE* APPowwtNTOATS: <br />Tine: <br />(Piss" allow 10 e WM464 de7e hem dab of epplkadon submataq <br />M CHECK BOX TD EXPEDITE REQUIST • 103,ee Pao- REQUEST PR tD IN 7 INlaa DAYS <br />OIGNATURE OP APPLICANT ('�j/�Jyj�.;,i DATE <br />ENVIRONMENTAL HEALTH DEPARTMENT FILEQ <br />0✓ <br />DeoMmsnt UN Onh <br />E3 Unit I I� 1 <br />Unit 4 1 <br />I <br />© Unito , <br />NDERGROUND TANK (UST) CLEANUP BrtE (LOPI <br />0 HOUSINQ ADATimENT <br />❑ SOLID WASTa FACILITY <br />CLaANUP8Y!(NONAAPJ0 <br />P00D PACnITY <br />O SOLID WAS?s VEHICLE <br />NOOROROUND TANK IMONR00.1NQ/0 <br />DOO KENNEL <br />DAaeY <br />ASAROOUsWASTEOENrPATOR <br />41,111'K" <br />0 CHICKIN RANCH <br />❑ PHS TREATmQNT PLANT <br />ER&D PERRITRDFACILITYCI <br />MOTELIHOTSL <br />O ►UMPoR TRUCK/YAROICHGM TOILETSATTOp/SOOT <br />PIERCING0 <br />POOLISPA <br />O LAND USE APPLICATION SITES <br />[DICAL WAl7E FACIL17i <br />C OTHER (PLEAS! SPECIFY) <br />1. List up to tan addresses In the Space above. Select the type(&) of files from the list aboys by oheelOnp <br />the appropriate box(es). At least one file type MUST be Selected. FPA to 12091 IM4335 Dr (pall tq t e <br />a <br />2. LHD will not y the app Icant it any 0HD tiles exist. An appointment for review will be confirmed <br />approximately five business days but no later then tan (10) days after recalpt of application. The flies <br />will be held for a maximum of five business days for review. Appointments should be Scheduled <br />accordingly. ' <br />31 A file that Is actively being worked on by EHO staff may not be immediately available for review. A new <br />application may be submitted when the (Ile Is available. <br />4. Any file not returned In the same condition is released will be reorganized by 9HD staff at the expenela <br />of the applicant. Future file reviews by the soma applicant may require a $03.00 deposit prior to review. <br />4. 'TENTATIVE appointment dates must be confirmed with HHD staff. <br />e.. Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENTOATE TIME <br />DATE CONFIRMED PHONE FAX thirrlAL6 <br />REVIEWED - YES NO REVIEW DATE <br />smell <br />