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08/09/2007 TRU 16.05 FAX 2(182999 SJC PUBLIC WORKS 2005/006 <br /> Is <br /> DATE RECEIVED '!! EHD LOG NUMBER <br /> SAN.]OAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTME3ca-1 <br /> 304 E Weber Ave 3rd Floor Stockton,CA 95820(209)468-3420 Fax: (209)464-0138 Web. www,co.san-oa utd �� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Claudia Gemberling BUSINESS/AGENCY: San Joaquin County Public Works Department <br /> ADDRESS: 1810 E. Hazelton Avenue, Stockton, California 95205 <br /> PHONE: 953-7624 FACSIMILE: 468-2999 <br /> TENTATIVE'APPOINTMENT DATE: <br /> (Please allow 10 6uslness days from date of application sudmittal) <br /> CHECK BOX TO EXPEOITE REQUEST/y-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS / [� n <br /> SIGNATURE OF APPLICANT ( �weo `/ ,1 y1.(�}/.e p iCj/ DATE I - <br /> if <br /> Department Use Only <br /> FILEADDRESS D UNIT <br /> / c S hi <br /> :. My W .2910 WI OnG, ❑ Unit 1 <br /> 11 0 "S G <br /> V' 50- 0 bt IIt Oil <br /> 19(; f� Unit <br /> — <br /> 1 5. Soret p20 — ( G <br /> `t�1 " s�mm �de2oL - I:la,♦- lll D c _. Urut3 <br /> �. awel " 1 vt0 11 <br /> D6 c <br /> 3 0?D T 0-S -( Unit 4 <br /> 9. s .k 3 u cit <br /> 1 c QLS G( ❑ Unit 5 <br /> CF ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACre, <br /> OTHER CLEANUP SIYE(NON-LOP) 0 FOOD FACILITY 'K SOLID WASTE VEHICLE <br /> UNDERGROUND TANK <br /> ENERAT RING/REMOVAL) ❑ DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH '4C PKG TREATMENT PLANT <br /> �•TIERED PERMITTED FACIPIERCING <br /> Y ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> rT MEDICALTATTOOIWASODY PIERCING ❑ POOLMPA ❑ LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY Q OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the types)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 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. 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 after 3:00 pm will be processed the next business day. . <br /> Ce)N�IRIVl�h:Pt'PtJlNrfni=yTATE 7iiNe. ` <br /> DATi3'caNFllzMeD PHptIE l6)t <br /> Off" <br /> . . tA1.S <br /> eHn 49-02-006 _' . ,.• .. <br />