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W-09-04 21:43 From-TTI TETRA TECH EM INC <br /> +9168520307 T-017 P.02/02 F-227 <br /> EHD LOG NUMSFR <br /> PATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTALIP F T <br /> ' "'� 304 F_ Weber Ave 3`'Floor Stockton,CA 9520 <br /> AUG 1 0 2004 (209)468-3420 Fax: (209)464-0138 Web:www.co.san-joaqu" .ca.u�/ehd <br /> ENVIRONMENTP03L1C RECORDS RELEASE APPLICA ION <br /> PERAPPu colli E i JN1� L � �v-2 t,USINFSS1AG iNCY: !� I K v CJ9 <br /> ADDRESS: lD�' C �/ �m� <br /> FACSIMILE: O�2 r 193 D <br /> P1tONE• 9lb - ��("� c� <br /> TENTATIVE'APPOINTMENT DATE: 2-0 ,` e�' l'`�y Time � <br /> (Please alloy 7o purines$days from dace of application suomi 1) <br /> I—r CHECK ROx TO EXPEDITE REQUEST-593.00 FEE-REQu EST PR E SE N 3 BUSINESS P Ys <br /> DATE <br /> SIGNATURE OF APPLICANT pepartme w Only <br /> UNIT <br /> FILE ADDRESS <br /> 7�} ,S-�• C. (] unit 1 <br /> 2 i.J� s f 0 ' Icy I " <br /> s G,, p _unit 2 -v <br /> Zai W 3-t. <br /> . ��M <br /> Ga unit 3 <br /> nj 5 4"ee[ <br /> co <br /> C. <br /> C jutfa[ <br /> Unit 4 <br /> 7, 54" <br /> C,ry <br /> 8 3veec <br /> ca unit 5 <br /> 9 Sapot r � " <br /> Ca <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILE <br /> FACILITY <br /> UNDERGROuND TANK(uST)CLEANuP SITE ❑ so D WASTE:(LOP) Q HOUSING ABATEMENT Q SO D WASTE FACILA_E <br /> OTHER CLEANUP SITS(NON-LOP) A FOO[)FACILITY ❑ D Y <br /> UNPRRGROUND TANK(MONITORINGIREMOVALQ) M DOG KENNEL M PK TREATMENT PLANT <br /> �{AZARPOUS WASTE GENERATOR CHICKEN RANCH <br /> (� TIERED PERMITTED FACII..ITY ❑ MOTELIH07(3L A PU PER TRUCK/YARD/CHF-M TOILETS <br /> ❑ TIERED PERMITTED <br /> 3ODY T ED FACT ❑ POOLISPA ❑ D USE APPLICATION SITES <br /> Q MEDICAL WASTE PIERCING <br /> 7Y M OTHER(PLEASE SPECIFY) <br /> above by checking <br /> I. List up to ten addresses in the space above. Select the type($)of files om the list <br /> the appropriate box(es). At least one file type MUST be selected. Fax t 209 AF,"138 or mail to the <br /> address indicated above. <br /> 2. (-110 will notify the applicant if any FHA files exist- An appointment for eview will bIca�nfi The files <br /> approximately five business days but no later than ton(10)days after r eipt of app <br /> will be held for a maximum of five business days for review. Appointor nts should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immedia ely 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 reorgan' d by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require $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 busines day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> PATE CONFIRMED <br /> PHONE FAX INITIALS <br /> REVIEWF40 YES NO REVIEW DATE T --- <br />