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/002 <br /> .10/21/2005 09:51 FAX 209 94808 0 002 <br /> p�`�r lveo SAN JOAQUIN COUNTY <br /> E+Nymov ENTAL HEALTH DEF"ITNa C7 <br /> OCT 1 605 304 E Weber Ave 3''Floor Stockton, CA 95205 <br /> ENVIROMM.Ek I f( n468-3420 Fax: (209)464-0138 Web: www.co.san joaquin.caus/ehd <br /> PER kl!Tii,E-RVICES PUBLIC RECORDS RELEASE APPLICAUON ` <br /> APPLICANT: R� JESLk�, -BUSINESSIAGENCY; IL <br /> ADDRESS: o R"�.r� p.C- M`l&T L., ST STcg-x-T: N-) C15-7C15-7hC" <br /> PHONE:`I 57 O ���I FACSIMILE:, 74 - 2412--V01-1 . <br /> TENTATIVE*APPOINTMENT DATE: r Time; <br /> (Please allow 10 business days from date of application submittal) <br /> 13 CHECK BOX TO EXPFOITE REQUESTV7.ba FEE-JUEST <br /> PROCESSED M 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ^ "� ' Qit /`�_ �_ DATE <br /> Department Use only <br /> FILE ADDRESS UNIT <br /> �� +• s� ❑ Unit 1 <br /> 2, Sae 0 a <br /> (b� Unit 2 <br /> 4. tic <br /> a)� <br /> S. sba n a ��nl `�� � <br /> N F E s Q <br /> r. swm Unit 4 O <br /> a s.moil <br /> ❑ Units <br /> +o. Stell <br /> IEAL.TH DEPARTMENT FILES If <br /> UHOERGROUND TANI �CQf9�� is 'SING ABATEMENT ITL SOLID WASTE FACILITY ' <br /> OTHER CLEANUP SR .J (Q 0 FACILITY E3 SOLID WASTE v6HiCL E <br /> I& UNDERGROUND TAN \^ IKENNEL IS-DAIRY <br /> as HAYARDOUSwA.9TE t} ZS (� `� CAS2.. :KEN RANCH 1�1-PKG YREATMENT PLANT <br /> ❑ TIFaPD PERMITTED 1 ✓/ �'EL/HOTEL c3PUMPERTRUCKIYARnicHEM TOILETS <br /> ❑ TATTOO/BODY PIER( (fid )LrSPA 18 LAND USE APPLICATION SITE$ <br /> ❑ MEDICAL WASTE FN IFR(PLEASE SPEC" <br /> 1_ List 4p 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 (2091464-0138 or mail to the <br /> addressindicated above. <br /> 2. EHD will notify the applicant if any EHO 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. A file that is actively being worked on by EHD staff may not be immediately available for review. Anew <br /> application may be submitted when the file is available. v+ <br /> 4. Any file not returned in the same condition as released will he reorganized by EHD staff atthe expens <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 /> B. Applications received after 3;00 pm wilt be processed the next business day. <br /> bNF1f3ME0`A PdIN7wi ,' : ! , TIMEN.2-QF3TE' 7. .77755. <br /> OATE•. sgNF.IRfiiED r; ..PHONEFAX",<,. ' ..1• iNl¢JQLS ' <br /> _ .. <br /> REVIENIED YES NO REVIEW DATE' <br />