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Fool. <br /> 09/03/2004 10:15 FAX <br /> EHD LOG NUMBER <br /> DATE RECEIVED r\ SAN JOAQUIN CO'UN'TY <br /> ENVTRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton, CA 95205 q0 <br /> SEP 0 3 2004 (209)468-3420 Fax:(209)464-0138 Web:www.co.san-joallum-ca- <br /> PUBLIC <br /> Iq <br /> ENVIRONS hEN1 HEA�/L]TH PUBLIC RECORDS RELEASEAPPLICATION <br /> PE APPLICANT: 1, X-/ �7 BUSINESSIAGENCY: 1 �`��4 Gy✓]n <br /> ADDRESS:I / �7�/Pv' v I�/�r Ir✓� 1 Lp%YILG d/YI /�" <br /> PHONE: %�f_J ! YV a � g-15 Z 6 FACSIMILE: '�'/J1l/)J- ZYt� OZ `-' 1 _ <br /> TENTATIVE'APPOINTMENT DATE: //V Time: �_V � <br /> (Please alloW 10 business days from dalo of application submittal) <br /> ,CHECK BOX To EXPEDITE REQUEST-$93. FES—RFQUrST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / DATE �/J <br /> Dopaflmant Use Only <br /> UNIT <br /> FILE ADDRESS <br /> ✓, ave. n rr oa '� p Unit 1 <br /> z sant i T <br /> a. sowx c9 <br /> aeI Unit <br /> a. V xUn <br /> CMY - — Unit 4 <br /> 8. RSI <br /> s cn _ ❑ Unit 5 <br /> ta. ssxt e <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> 7HER CLEANUP SITE(NON-LOP) D FOOD FA0I1.17Y O SOLID WASTE VEHICLE <br /> NOERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> RDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELMOTEL O PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOOIBODY PIERCING ❑ POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACIU Y 13 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)464-0138 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 applloation. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <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 atter 3:00 pm will be processed the next business day. <br /> EREVI1EEWM::: <br /> FIRMED APPOINTMENT DATE. � '' TIME .: <br /> PHONE .FAX INITIALS <br /> E.CONFiRMEO;:: 'YES '..:.._ NO REVIEWD"ATE!;:,HD aeazaa - <br /> eraaaoa <br />