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12/28/2003 18:38 9252836121 AEI CONSULTANTS (SF) PAGE 01 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> 1 ENVIRONMENTAL REArm DEPARTMENT <br /> 304 E Weber Ave 3"dFloor Stockton, CA 95205 <br /> DE 468-3420 Fax: (209) 4640138 Web: w,avw.co.m-ioapirl-ca.us/ehd <br /> NV ii-i vfv CNS 1 1 L! ; PUBLIC RECORDS RELEASE APPLICATION C <br /> APPLICANT: Yl r ` BUSINESSIAGErrN��CY: <br /> ADDRESS: tl1D lD <br /> P :C�2 ) ✓ � / Qi " FACSIMILE: <br /> HONE <br /> TENTATIVE*APPOINTMENT DATE: n Time: Ind m <br /> (Please allow 10 business days from date of application submittal) f <br /> CHECK SOX TO EXPEDITE REQUEST-$93.00 F E—REQUEST PROCESSED IN 3 BUSINESS DAYS J <br /> SIGNATURE OF APPLICANT L41A � DATE I �V �7 <br /> 1` Department Use Only <br /> FILE ADDRESS UNIT <br /> 1, g„ 210 ,VJt sor. & aly ❑ <br /> 2- Stream a r, Ali P► ,�-�,3- <br /> 3. St,e �i iiW I WLL G i1 Unit '2 <br /> 4: Street Itl. b O 1 l <br /> ( INa u Unit 3 <br /> 5. Street 1 <br /> t3. Slrcat ( l- G <br /> 7. Street -�I'1 weS o I Unit�4 <br /> B. Sued Z 0 (1 t <br /> 9. S. 1 1 G ❑ Unit 5 <br /> 10. Suaet <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 1 <br /> `9� UNDERGROUND TANK(UST)CLEANUP SITE(LOP) L1 HOUSING ABATEMENT A SOLID WASTE FACILITY <br /> 1M OTHER CLEANUP SITE(NON-LOP) 11 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> M UNDERGROUND TANK(MONITORING[REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> �k HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 5k PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY D MOTEUHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOOI60DY PIERCING D POOLISPA ;K LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECiFIn <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checkinc <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 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 ne, <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 revie <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 /> CONFIRMED TIME APPOINTMENT DATE . <br /> DATE= CONFIRMEDPHONE FAX' IN1TtotLS` <br /> REVIEW DATE <br /> REVIEWED YES NO ' <br /> 8/8l21l4J <br />