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03/09/04 14:17 UCD Ct & ENV ENGR 4 912094640130 NO.e55 DC, <br /> . Apr <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY' <br /> ENMON1VIENTAL HEALTH DEPARTMENT <br /> U o � 304 E Weber Ave 3rd Floor Stockton,CA 95205 <br /> MAR 9 2004 (209)468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.cams/ehd 1014 <br /> ENVIRONNAPNT HFALIH PUBLIC RECORDS RELEASE"PLICATION <br /> PERW;aRTVIC�u JV Akdsr rte• BUSINESSIAGENCY: & f 4 <br /> A00115SS• (7 1 t7 .]_ Aoc eA i <br /> PHONE: q16- $CZ- 8oS'8 FACSIMILE: <br /> A41AIL.. <br /> TENTATIVE'APPOINTMENT DATE: l w ''tTj(1 Oi Time: �^'�TI ` T'�• M�r`� <br /> (Pleasa allow 10 businoss days from date of application submittal) <br /> 01"CHECK BOX TO EXPEDITE REQUEST• 3.0r E- QUE PROCESSED IN 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT DATE 3 G <br /> Depadmsnt Use ONy <br /> FILE ADDRESS UNIT Y <br /> a` ❑ Unit 1 <br /> -r saes/ a.l �• i a pi � <br /> s. � Q ❑ Unit 2 <br /> 4. meat cn <br /> S. Sbeat G <br /> A. S&M( <br /> T. saeel at oUnit5 <br /> a. s"I M a. sam1 at <br /> i0. Sneei ql <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES [ <br /> eUNOERGROUND TANK(UST)CLEANUP SITE(LOP) C7 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> $'OTHER CLEANUP SITE(NON-LOP) C] FOOD FACILITY d SOLID WASTE VEHICLE <br /> 4!!r UNDERGROUND TANK(MONITORINGfREMOVAL) ❑ DOG KENNEL 0 DAIRY <br /> .P?'HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY A MOTEL/MOTEL 11 PUMPERTRUCKIYARO/CH TOILETS <br /> 0 TATTOOIBODY PIERCING 0 POOUSPA 0 LAND USE APPLICATION SITES <br /> o MEDICAL WASTE FACILITY M OTHER(PLEASE SPECIFY) <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. Egg to(2091464-0138 or mail to the <br /> addmss 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 EHD 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 RATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> ENL 4842406 <br /> 61W003 <br />