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08/26/2003 11:35 209467 18 AGE STOCKTON PAGE 01/0 <br /> 1 tnu wv Numol;;. <br /> SAN JOA.QUIN COUNTY ..-1' 1. <br /> ENVIRONMENTAL HtAun DEPARTMENT ' <br /> AUG 2 6 Z063ppgg 304 E Weber Ave 3'a Floo.r Stockton, CA 95205 <br /> ENVIRONMENT H A 7T 468-3420 Fax: (209) 464-0138 Web: .co.san-joaquin.ca.us/chd <br /> 460 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT., BU;INESSIAGENCY:&AyAGcd &D lyingnme? <br /> ADDR>rSS: S3 Shaw a Stockton �j Jl <br /> PHONE: aO . • 1400 FACSIMILE: <br /> I <br /> TENTATIVE'APPOINTMENT DATE: Time: ZQ-W <br /> (Please allow 10 business days from dat of application subm ttal) <br /> �i CHECK BOX TO EXPEDITE RE q -$93 00 FEE—RE91_1ST PR CE ED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS �j UNIT <br /> c1J Unit 7 <br /> 2. Street ODl <br /> J <br /> Street . 49 ro t4) aty O t It 2 <br /> s <br /> Me <br /> 5. Sweet . u 0 <br /> e, swot <br /> city7 d <br /> r. sneer Q ty Unit 4 <br /> B. surer CI <br /> 9. street a ❑ Unit 5 <br /> M Sb W GI <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY d SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) d DOG KENNEL 10 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> Cl TIERED PERMMED FACILITY ❑ MOTELIMOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> LI TATTOOIBODY PIERCING • U POOL/SPA Q LAND USE APPLICATION SITES <br /> Ci MEDICAL WASTE FACILITY E3 OTHER(PLEASE: PECI" <br /> I. List up to ten addresses in the space above. Select t)°e type(s) of files from the list aboye by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fa_x_to (209 464-0138 o.r mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHD flies exist Ai appointment for review will be confirmed <br /> approximately five business clays but no later than to (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 m y 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 release d will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same app (cant 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 /> FM <br /> CONFIRMED APPOINTMENT DATE TIME <br /> 80 1A <br /> DATE CONFIRMED PHONE FAX INMALS <br /> REVIEWED YES NO R VIEW DATE <br /> L-90 4842Wr, <br /> ararmaa <br />