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Jan 03 05 10: 03a Rob L Nicholson 916--l - -3073 p. 2 <br /> V'. EHD LOG NUMBER <br /> ATE RECEIVED SAN JOA UIN COUNTY <br /> Q <br /> r �VE� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton,CA 95205 <br /> �►�; 3 20@509) 8-3420 Fax: (209)464-0138 Web: wNv-w.co-san-joaquin-r-a.us/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: <br /> Bob Nicholson BUSINESS/AGENCY: RNC Environmental <br /> ADDRESS: <br /> 9746 ParkLree Way,Elk Grove.CA 95624 i <br /> PHONE: <br /> 916-714-3073 FACSIMILE: ��2 ��' m �3 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> pigftWy signed by Robert A.Nlcndsm DATE <br /> pate:2005 41 <br /> .01.03 09: :57-08'W <br /> SIGNATURE OF APPLICANT <br /> Department Uso Only <br /> UNIT <br /> FILE ADDRESS <br /> \� itis ,t 1220 Fast Pine Lodi ❑ Unit 1 <br /> v 115, 2. street 1240E Pine St c Lodi <br /> 3 srej 213 South Kelly Street c Lodi Unit <br /> NIF 4 1220 Victor Rd c Loll <br /> MJF 5. sheet 32 N Cluff etc �� Unit 3 <br /> N 100 S Cluff Ave Lodi <br /> 6 s`i`t fid; Unit 4 <br /> '�'S T r sre�t 200 S.Beckman c <br /> rJ I F e greet 902lndustrial c Lodi <br /> El 5 <br /> � <br /> 9. Street <br /> 10. Street � <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> HOUSING ABATEMENT X SOLID WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) FOOD FACILITY SOLID WASTE VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) DOG KENNEL DAIRY <br /> UNDERGROUND TANK(MONITORING/REMOVAL) CHICKEN RANCH PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR MOTEUHOTEL PUMPER TRUCKNARD/CHEM TOILETS <br /> X TIERED PERMITTED FACILITY LAND USE APPLICATION SITES <br /> TATTOO/BODY PIERCING POOUSPA <br /> MEDICAL WASTE FACILITY LjOTHER(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 leastone file type MUST be selected. Fax to(209)a64-0738 of 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 fifes <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 END 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 /> y require a$93.00 deposit prior to review. <br /> of the applicant. Future file reviews by the same applicant ma <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 /> CoNFIRNIED APPOINTMENT DATE i TIME <br /> DATE CONFIRMED <br /> PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHDA"2.0% <br /> &M=03 <br />