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/f11/22/2004 14:34 FAX 209 9480021 Q002/002 <br /> L {� <br /> SAN JoAQuuN CoutvTx � /OO <br /> ENVIRONNxEEN'TAL HEALTH DEPARTMENT G `i <br /> NOV 2 2 2004 304 E Weber Ave 3`d Floor Stockton,CA 95205 <br /> 11 468-3420 Fax: (209)464-0138 Web:www.co.san joaquin.ca-tufohd <br /> ENPER�(T SERVIC�ES�� <br /> PUBLIC RECORDS RELEASE APPMCAnON <br /> APPLICANT: 7'Y"„- :1 de,SI'$ BUSINESSIAGENCY: lGirlfGl ` <br /> ADDRP9S:� .ZBai .f 1!Ryrlfa s{•Aeg+ Sib cIL,., e-t qS-,P E <br /> PHONE: 14� FACSIMILE: 0�-D9�9�1� OCe.Z•t ` (; /`' ��\7 <br /> TENTATIVE'APPOINTMFNT DATE: Ia l3 nme' <br /> (Please allow 10 busiru-4_s days from date of apPli=tI<M submits-4 v <br /> LJ CHECK BOX To EXPEDITE REQUEST-193.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT f - DATE <br /> Deoattment Use ONY <br /> UNrr <br /> FILE ADDRESS <br /> ML7ftoo <br /> FQMuJ oel ❑ Unit 1• <br /> [ij.- 1 �. % s '+ Unit 2AQQ <br /> 3 �- }P,r Ra o Unit 3f S o e �Unit40 M A• 0 STeo ❑ Unit 5 <br /> Ito <br /> -ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)cLEmvP SITE(IAP) I] HOUSING ABATEMENT SL SoUO WASTE FACItRY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOUD WASTE YEHNCLE <br /> IP UNDERGROUND TANK(MONITORINCIREMOVAL) 0 DOC KENNEL 19.DAIRY <br /> AD HAZAR000S WASTE GENERATOR O CHICKEN RANCH &-PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑ NOTELHOTEL 0 PUMPERTRUCKrrARD/CHEMTOILETS <br /> CITATTOOISODY PIERCING ❑ POOLISPA LAND USE APPLICATION SITES <br /> ❑ MEDICAL.WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to Len addresses in the space above. Select the type(s)of files from the list aboye py 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 EHO files eXisL 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. Ane <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 expens <br /> of the applicant Future file reviews by the same applicant may require a $93.00 deposit prior to revi <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> E. Applications received after 3:00 pm wilt be processed the next'business day. <br /> CONF.�F�M,E,U'i4P.ROINT)r1ENTpA.Tfi"' : -;r.3;•-r•,_��,.'TIME •_:u�•'-::•��.;'- <br /> N; h`'PFIOkIE': FAX•-:' INFL4l 5 it <br /> "I1ATE•GaNF1Rlt�EU <br /> IkEVtEN/ED YES NO REVIEW DATE; ' ,.. <br /> E,to re.a=aac - <br />