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c MODESTO ATC PAGE 02 <br /> 12/16/2003 17:54 2ec 9-2225 tr+u wv NVMt <br /> � SAN JoAQUnv CaUNTY�`'� <br /> ENVIRONMENTAL REALTH DEPARTMENT <br /> ;_— 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> (( 09)468-3420 Fax: (209)4640138 Web:www.co.San}oaquin.ca..u91ehd <br /> 1)��.� ? � ZOa i <br /> :. PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT''; `n' BUSINESSIAGENCY- <br /> l- ons G I-r,- <br /> CA <br /> r7 <br /> ADDRESS_ -7 q <br /> PHONE:fr � 1 l 1 _FACSIMILE!_r1 04_ S-76-22a S— <br /> TENTATIVE'APPOINTMENT DATE: 15r-)'3 nR'a: <br /> r' w <br /> (pie,wa allow!0 business drys from t•b of A tomonsubmKU4 <br /> CHECK BOX TO EXPEDITE REQUEST•$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> papsrtrnant Tisa QnN <br /> FILE r,D13RESSto— <br /> UNIT <br /> a 1'6 6 Unit 1 <br /> G � <br /> 2- �u. <br /> d ❑IUnit 2 <br /> � <br /> � <br /> 4, 8"M } 1,1nk 3 <br /> a <br /> e. <br /> Unit 4 <br /> e. s� nrt 5 <br /> A ati..i S T <br /> 10. <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(i13I)CLLANUP SITE(LOP) ❑ HOUSING ABATEMENT L7 SOLID WASTE FACILITY <br /> THER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ DAIRYSOLID WASTE VEHICLE <br /> CkVNDIERGROUND TANK(MONTTORINGIREMOVAL) C3 D043 KENNEL o DAIRY <br /> R- AZARDOUS WASTE GENERATOR C1 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERmtTrED FACILITY ❑ moTELMOTEL ❑ PUMPER AppuYAnON SIT TOt1.ETS <br /> 0 TATT00/BODY PIERCING la POOLISPA Q LAND WE APPLICATION BITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above by eheeidni <br /> the appropriate box(es). At least one file type MUST be selected. FI,ta (2091464-one-or mall to the <br /> AIg as 1 dlcatjW ab ve. <br /> 2. EMD will notify the applicant N 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 no <br /> application may be submitted when the file is available. y ens <br /> 4. Any file not returned in the same condition as released will be reorganized b EHD staff at the exp <br /> of the applicant Future file reviews by the same applicant may require a$93.00 deposit prior to revia <br /> S. '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 /> ------------- <br /> CONFIRMED APPOINTMENT:DATIii ,':: Ti <br /> PHONE pA)( .. 'ITtAL.S' <br /> DAT i CONFIRMI:.q .:: `- - <br /> NO ... <br /> REVIEWED 'YES REVIEW DATE. <br /> r�o ss-u-oc� - -• <br /> u.rsoos <br />