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06-10-'04 10:13 FROM- W.A. CRAIG INC. 707-693-2922 T-900 P002/002 U-029 <br /> END LOG NUM <br /> _Tr�Vn) SAN JOAQUINCOUNTY "� I <br /> JUN 1 0 2004 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ff 304 E Weber Ave 3nd Floor Stockton,CA 95205 <br /> ENVIRONMENT HEAL 5l)468-3420 Fax:(209) 464-0138 Web:www.co.san-joaquin.c2.uS/ehd I <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> p <br /> APPLICANT: 66a BUSINESSIAyG�ENCY: 1 <br /> ADDRESS:���O Tremnn� R�, DIxoh Ott `1500 <br /> FACSIMILE: 1� d <br /> TENTATIVE'APPOINTMENT DATE: "/ 'Dy ,11e; $:30 am <br /> (Please allow 1 O bUsineas days f om dot 11 submittal) <br /> XIG <br /> HECK BOX TO EXPEDITE REQUEST•=9 .00 FEE—kE EST PROCESSED IN 3 BUSINESS DAYS <br /> ATURE OF APPLICANT 11 DATE. L� / <br /> r6nent Use Only <br /> FILE ADDRESS UNIT <br /> ,. ON u rl11 ef,# 5.23-7 ❑ Unit 1 <br /> 2. <br /> �IU� ( � <br /> a I' rT <br /> at« o ❑ Unit 3 �A <br /> a. Ka <br /> ON <br /> r arm -ON Unit 4 <br /> • d <br /> e, so <br /> r <br /> Ie. Stet <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> _ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT J ,SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY O SOLID WASTE VEHICLE <br /> O UNDERGROUND TANK(MONITORINGMEMOVAL) O DOG KENNEL 4 DAIRY Ef <br /> QHAZARDOUS WASTE GENERATOR O CHICKEN RANCH O PKG TREATMENT PLANT 1 <br /> C3TIERED PERMITTED FACILITY Q MOTEUHOTEL 0 PUMPER TRUCK/YARD/CHEM TOILET <br /> TATTOOIRODY PIERCING C3 POOLISPA A LAND USE APPLICA-n N SITES <br /> MEDICAL WASTE FACILITY ywTNEk(PLEASE SPECIFY) (J)e' L C3_ " Alp Ll <br /> 1. List up to tan addresses in the space above. Select the type(s)of files from the list aboye by checki; <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 12091464-0138 or mail to th <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 file <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 r <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 expel <br /> of the applicant. Future file reviews by the some applicant may require a S93,Ob deposit prior to rev <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6, Applications received after 3:00 pm will be procassed the next business day. <br /> CONFIRMED APPOINTMENT GATE <br /> TIME d. ` <br /> DATE CONFIRMED PHONE FAX `INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> uo�.eos <br /> uersow <br />