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09/09/2004 '09:14 ' 9252836121 - AEI CONSULTANTS'-(SF) - ..PAGE -:01 . . <br /> v Vj —� END LOG NUMBEi <br /> i LQ \J I �Q �; SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SEP 0 9 2004 304 E Weber Ave 3'-j Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:www-co.sau-joaquin caus/ehd <br /> ENVIRONMENT HEAI-TH <br /> PERMIT/SERVIGES P <br /> UBLIC RECORDS RELEASE APPLICA110N <br /> APPLICANT: <br /> o(,�3SBUSINESS/AGENCY: CEJ C,f �C�kd.�- <br /> ADDRESS: ^Gc> y �AWnj Cfle <br /> PHONE: aJ3t <br /> - <br /> Ua7O FACSIMILE: 9915 U19LI <br /> TENTATIVE"APPOINTMENT DATE: LJ Time: 'O <br /> OIA 0" n ym' 4M <br /> (Pleeaase�allow 1L0business days fromdateof a�pvplilijc-ation submittal) <br /> 4, `lam <br /> CHECK BOX TO EXPEDITE RFQUt_'ST-4 3 00 F E QUES ROLE IDI N 3 BUSINESS�~ jq <br /> SIGNATURE OF APPLICANTL DATE �l Iq <br /> Department Use Only <br /> FILE ADDRESS UNrr <br /> 1. sem 35th at51' coil R a S ,n n ❑ Unit <br /> z. So-cd 3<0 95- E. G e. k a " 7 <br /> s. so-eai 2 5/i- -Zi a " Ua5 Z 5. 5 _ Tf Unit 2 <br /> .• n <br /> a yt tZ A E5 / <br /> s. sues IS W N. a U 2<� fY n yr Unita <br /> (SO G " 1 P a Z 1R i <br /> s NiFM '59W N• W a V* <br /> ENVIRONMENN�TTAL HEALTH DEPARTMENT FILESUNDERGROUND TANK(UST)CLEANUP SITE(LOP) J�' FOODIFACILtTYNG EMENT U SOLID WASTE VEH <br /> 13.OTHER CLEANUP SITE(NON-LOP) ❑ DAIRY <br /> UNDERGROUND YANK(MONrrOEiINGlREMOVALJ ❑ DOG KENNEL ❑ PKG TREATMENT PLANT <br /> ]�HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 11,,,, <br /> TIERED PERMITTED FACILITY ❑ MOTEIIHOTEL PUMPER TRUCKIYARDICHEM TOILETS <br /> O TATTOofsooy PIERCING In POOLISPA LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above py 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. END will notify the applicant if any EHD files exist An appointment for review will b®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 neH <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 revie% <br /> 5. 'TENTATIVE appointment dates must be confirmed with END staff. <br /> 6. Applications received after 3:00 p'm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE <br /> TIME K <br /> DATEf)ONFIRMEO PHONE FAX INITIALS <br /> REVIEWED i YES NO REVIEW DATE <br /> eno�s.ozavc - . <br /> A <br /> Nl2609 <br />