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AUG. 1/. 1UU4 4:4UNM `'')NUUK EAR I H I ECH N0. 6355 P. 1 j <br /> DATE RECEIVED EHD LOG NUMBER <br /> l -�r , SAN JOAQUIN COUNTY <br /> I'� ln� FNVIROI'MENTA.L HEALTx DEPART ENT <br /> 304 E Weber Ave 3`d Floor Stockton, CA 95205 <br /> AUG 2.7 ZOPO)468-3420 Fax: (209)464-0138 Web: vivw.co.san-joaquin,ca.us/ehd <br /> ji �f�iL' FicW� pUBLYC RECORDS RELEASE APPLICATION <br /> PpFFR�1MITI II� rr� / <br /> ft21CIA,NT: 4.r f.f�. 1CcL L+..25 13VSINESSIAGENCY: er f halo iP5 1fiTC. <br /> ADDRESS: 8 a i S �Dc 1ti �[ 2p Co <br /> PHONE: 4 O 9 - 2.3 -osm FACSIMILE: 2 0°1 2.3 ^Q 4Z;38 <br /> TENTATIVE"APPOINTMENT DATE: /O SQ pte &)- .ZOO rme:_8.'3 o AM <br /> (Please allow 10 business days from date of appllcatlon submittal) <br /> El CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—RE EST PR ESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 8/,--it D <br /> D"Partmd Use Only <br /> FILE ADDRESS LL II UNIT <br /> 1, 91rea1 •K Cil SipGlG <br /> ❑ Unit 1 <br /> ❑ Unit 2 <br /> k gvag mar:i nT <br /> cis 5� flfi aE5( ,. t Unita <br /> 6, rse Q v O. C i <br /> 7, GbKL (, �� ajy 5e)n' Unit" <br /> Q J � <br /> GI n ❑ Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES Xit 61l� <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY SOLID WASTE VEHICLE <br /> IX UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL DAIRY <br /> 'M'-HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH q PKG TREATMENT PLANT <br /> ?9-TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TF2UCKIYARDICHEM TOILETS <br /> ❑ TATTOO/BODY PIERCING ❑ POOUSPA - ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACIUTY 0 OTHER(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 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 END staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> a RI Eb; p• `attuTl i l ri T ; '„ .fine <br /> FAX <br /> tEV <br /> J1I <br /> D 48-02-006 <br /> U012003 <br />