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MAY. 19. 2004 10: 34AM WATERSTONE ENV. 714-414-1166 N0. 9722 P. 2/2 <br /> DATE RECEIVED i ' EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAY 1 9 200 304 E Weber Ave 3'"Floor Stockton,CA 95205 <br /> (1109)468-3420 Fag: (209)464-0138 Web: www,co.san-joaquin.ca.us/ehd <br /> ENb9R M1T/SFR1ilr�c VT HEALTH <br /> PERMIT/SPUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Brianne Gibson BUSINESSIAGENCY:Waterstone Environmental <br /> ADDREss: 2936 E. Coronado Street, Anaheim, CA 92806 <br /> PHONE:714-414-1122 FACSIMILE:714-414-1166 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Plain allow 10 business days firm nate of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST.S93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> i. swat 2020 North MacArthur Drive a Tra . ❑ Unit 1 <br /> a. elan 502 East Grantline Road G„ Tra <br /> GI <br /> easel [IUnit 2 Ilj Z7 O y <br /> Gl <br /> S. boeel Gi Unft 3 dna) <br /> 6, wear G / <br /> t. bnm City U04 <br /> A, Speer G <br /> 9, stet G ❑ Unit 5 <br /> ,p. elrvm <y <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP S1TE(NON-TOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK IMONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> CIE.HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> M TATTOOtWI)Y PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 1209)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 END 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 EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EMD,ae24NI <br /> PVSOPJ <br />