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10/13/2003 12:33 9252836121 AEI CONSULTANTS (SF) PAGE 01 <br /> DATE,,RECEIVED EH0 LOG NUMBEF <br /> ; ! SAN JOAQU•IN COUNTY <br /> ENvmoNmNTAL HEALTH DEP.ARTMMNT <br /> 0 C T 1 3 2003 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> (209) 468-3420 Fax: (209) 464-0138 W6: www.co.san-joaquin.ca.us/ehd 10 <br /> fLftLil <br /> i'E:..y`:'I : E `iiCES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:����1 1 s Ll ) BUSINESS/AGENCY: <br /> ADDRESS: 2�boU fit_ 1rni D(�. iy .Si, . 200 aalr�ut �.rPe n,� a M -- <br /> PHONE: �� �433��n..dDc� Zr X15 FACSIMILE: I�� C,�CJ <br /> TENTATIVE'APPOINTMENT DATE: 04 21 , 2,o b 3 Time: 11am <br /> T <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93 0 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE t0 I_J (D3 <br /> Department Use Only <br /> FILE ADDRESS I UNrr <br /> 0 Z f ci oncamo ❑ Unit 1 <br /> el G <br /> p s G Unit 2 ( I J <br /> City it Ge <br /> 4 1 s, s7e9t 2 cityIt K Unit 3 <br /> t� 7 <br /> 8, les $ Gh2 2 <br /> 7. stem aty Unit 4 <br /> e. s1r>e city <br /> s• str c p Unit 5 <br /> 10. Strcd G <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> �Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT A SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> Q UNDERGROUND TANK(M ONITORI NGIREM OVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑ MOTELJHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> © TATTOO/BODY PIERCING ❑ POOLISPA M LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) '-IOL D'flh;:, Shi[�{� ,DC7t <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by 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 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 applicatlon. 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 nem <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 reviem <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- INfT1aLS ' <br /> REVIEWED YES NO REVIEW DATE J <br /> EHD 48-02-0OG <br /> &872003 <br />