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Q/'TE aECE1VEP I31D we NVMPER <br /> SAN JOAQUIN COUNTY <br /> I:NVIRONMENTAL HEALTH DEPARTMENT I <br /> MAY 1 6 1003 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> N 68 : <br /> (209)4420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANTf"ae-j!_-iLl e. BUEINBSSIACE`NNCY_, /±r� ,''/r <br /> ADDRP.SS 4LZ2 .'! 7I Al L. G"9-8& �A / . E k SP—PW <br /> PHONE—�y;!U L.. 2'iC..L—FACBIMIL r �7 U <br /> TENTAWINE'O.PPOINMIENTDATE TIME �I •�JI 0 `�✓ s� <br /> (PFgsa eats 7 to 70 buslwss days froze data of application subinittel) ; 3 <br /> CHEiKBOx TOE%PEDIILRECU 1ESSED IN 3 BUSINES8 DAYS <br /> SIGNATURE OF APPLICANT y(}4d1Y(� .(/�' DATE <br /> rS <br /> PILE AIiDRESS MIS SIDE D STAFF USE ONLY <br /> N,1615 <br /> ) PROGRAM ELEMENTS SEARCH <br /> � I� L <br /> 4E <br /> ENVIRONMENTAL IEALTH DIVISION FILES <br /> )F UINDE RGROUND TANK(L'BT)CIXINUP COTE(LOP) 0 HOUSING ABATEMENT 13 SOLID WASTE FACILITY <br /> 0 OTHER CLEANUP SITE(f:ON•LOPI 0 FOOD FACILr,Y O SOLID WASTE VEHICLE <br /> UNDERGROUND YANK(1 I01,1179RINGMEMOVAL) 0 DOG KENNEL 0 DAIRY <br /> G HAZARDOUS WASTE GE 4ERA'rO1: 0 CHICKEN RAfICH ❑ PKGTRFATMENT PLANT <br /> ❑ TIERED PERMITTIED FAC'I_ITY 0 NOTELIHOTEL 0 PUMPER TRUCKIYAR tCHEM TOILETS <br /> 0 TIERED lERMI PIERCING; 0 POOLISPA CI LLAAt�{U USE APPLICATION <br /> 0 MEDICAl,WASTE FACIU rY X0 OTHER(FLpE�+SE SPECIFY). <br /> t1IAT�L� �'f1NT 1 A_ <br /> Na a ( vJS <br /> 1. List up fo ton to addruMAS <br /> s in the <br /> reaspace file ve. Select <br /> the <br /> e see(ted f Faxsttr(2091 om a 1464 01ist 8vorbmaf chocking <br /> the appropriate ( ) type <br /> ar�lresN indiC ate ab ov <br /> 2. EHD will nobly the applicant if any EHD files exist. An appointment for revlew 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 nterimum of five business days for review. Appointments:IhoUld be scheduled <br /> accordingly. <br /> 3 A file that is k.ctive,ly being worked on by EHD staff may not be immediately available for review. A new <br /> application n uy bo submitted when the file is available. <br /> 4. Any fila noi'trtturned in cunt. F'uturethia same filer views byion as thesameloased f3pplicantlbe mayreequ requirezed by EHD staat the eense <br /> a$8&00 deposit prior t xrp <br /> of the app eview. <br /> 5• 'TFNTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applieafiens Ieceived after 3:00 pm will be proreased the next business day. <br /> 4. <br /> Apt' <br /> AYE. <br /> CC1E•IF:U3N�� - �.:.._ - <br /> TE"ONFfRMEf= ; ,: ..-.. P.i7?NS�:e <br /> aa <br /> _. <br /> qA' .'N _--�"'."'S•;; <br /> Aai1.00a <br /> 1•W7 <br /> I �I abed Bi. 0090E:810LL8ilb veay ue66:01 fe-ZZ-uef :Fq }uaS <br />