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SAN JO.A,QUIN COUNTY � EHD LOG NUMBER <br /> ltllL�(CL h VII20NMENTAI, EAX,'I'HDEPART�MENT <br /> 304 E Weber Ave P Floor Stockton, CA 95205 <br /> (209) 468-3420 Fax: (209)464-0138 Web: www.co.san joaquin.ca.USlehd 25 7 <br /> MAR - S 2006 <br /> E PUBLIC RECORDS RELEASE AVPLTCATION _ <br /> ^� �13USINESSiAGENCY: r^r�►SU 1 LAYS i A&sa C _ <br /> ADDRESS q0 [r llld.J�`Olj <br /> PHONE: 3 - � � FACSIMILE:_. lY_ <br /> TENTATIVE*APPOINTMENT DATE: 1 {} Time: If <br /> (Please allow 10 business days from date of application snbmittai) <br /> CHECK 13OX TO EXPEDITE REQUEST-$93.00 FEE-- EQUEST PROCESSED IN 3 BUSINESS DAYS <br /> //SIGNATURE OF APPLICANT DATE c� h <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> 7 8trecl /�f Gt <br /> �� LAM <br /> 2. Street Ql ❑ Unit 1 <br /> 3. StrcN UD � �' G <br /> A. Stn 1 0 2, A- of �50�'7 C� Unit 2 I� <br /> al <br /> e. stmefT. <br /> Un,t 3 <br /> ut <br /> e. Street 1611t <br /> Gt <br /> 8. S2rrot <br /> CII �a et're _ •, 3> �=i` %r <br /> 10. Street el p Unit's <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT 13 i SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) iD FOOD FACILITY ❑I SOLID WASTE VEHICLE <br /> IS' UNDERGROUND TANK(MONITORING/REMOVAL) ❑ POG KENNEL <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCHC7(DAIRY <br /> 7tQ TIERED PERMITTED FACILITY 13 I PKG TREATMENT PLANT <br /> C3TATTOOI80DY PIERCING MOTELIHOTEi, O(PUMPER TRUCK/YARwcHENi TOILETS <br /> © MEDICAL WASTE FACILITY 4 POOLISPA © LAND USE APPLICATION SrrEs <br /> Q 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. 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 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 /> CON =APPOINTMEINIT �1ATE TIME <br /> DATE PHONE FAX1NITIAISREViENO REVIEW DATE <br /> EHP 4a-52•oao <br /> aB2oo� <br />