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[a 003 <br /> 1,%28/2004 13:24 FAX 209 9480 0 0 11.1 <br /> DATF RECEIVED SAN 'JOAQUIN COUN-CX <br /> EWMONMENTAL REALT)3 DEPARTMENT <br /> 304 E Weber Ave 3d Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:VrV/W.ro.san-joaquin.mus1ehd. <br /> PUBLIC RECORDS RELEASE APPLICATION TION <br /> APPLICANT: �nprivy BUSINESSIAAGEHCY:_j Irer (L" { <br /> _ (+ <br /> ADDRESS: ax7-•F��' !/1t Irtl-Q-. -Ca �lo4ZFOn� UQ YSO — <br /> PiiQNE: 2I iiy – FACSIMIILE: 9�a-cxpar <br /> TENTATIVE'APPOINTMENT DATE: II f I Til ma: "�✓ <br /> (Please allow 10 business days frau date of application submntal) <br /> ❑ CHECK BOX TO F]: FDrrE REQUEST-593.00 FEE—REQUEST PROCESSED tN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _!��� DATE <br /> DaPartnw�t Use OMv <br /> FILE ADDRESS UNIT ` <br /> {i 'i t, sswl Q F 1 QITu\ ^ Gl t Unit 1 <br /> c cs�ka.. �.� -bn <br /> ii YL s. sveei G� U,1Son. wfl z fbn Uni[Z <br /> sate Unit 3 <br /> e- s rcx City <br /> Unit 4 <br /> Cky <br /> e. sv�el � Unit 5 <br /> 9- SUeM <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES `�' <br /> O ❑ HOUSING ABATEMENT a SOLID WASTE FACILITY <br /> ( 9 UNDERGROUND TANK(NON CLEANUP SITE(L ❑ FOOD FACILITY Cl SOLID WASTE VEHICLE <br /> IS OTHER CLEANUP SITE(NON-LOP) ' <br /> 10 UNDERGROUND T/WK(MONITOW13 DOC KENNEL OL DAIRY NGIREMOVALl 0 <br /> ❑ CHICKEN RANCH U PKG TREATMENT PLANT <br /> ,M HAZARDOUS WASTE GENERATOR ' ❑ MOTELIHOTEL [3PUMPER TRUCKrYARDICTIEM TOILETS <br /> ❑ TIERED PERMITTED FACILITY ❑ POOIJSPA V. L AND USE APPLICATION SrrES <br /> ❑ TATTOOMODY PIERCING ❑ OTHER(PLEASE SPECIFY) <br /> 0 MEDICAL WASTE FACILITY <br /> type(s)of tiles from the list above <br /> 1. List up to ten addresses in the space above. Select the py checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0118 or mail to the <br /> address indicated above_ <br /> 2. EHD vv)II notify the appfiGint if any END 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 he held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. AFIe 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 /> g, Applications received after 3:00 pm Will be processed the next business day. <br /> TIME Yy; ;;- :• ., <br /> CONF:LRM P`X PoiNThiEtrrDATE. ` <br /> UATE'Gl?NFIRMED' !.PHONE' iN171A1 S <br /> . . REVIEW DA <br /> TE'. ' i ;.: .. <br /> REVIEWED .- 'YES NO <br /> ' EFS b-02.Ue6 <br /> ereaaar <br />