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09/15/2009 10:23 9257466099 AEI CONSULTANTS PAGE 01/01 <br /> HEMMED <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SEP 1 5 2009 600 East Maul St. Stockton,CA 95202-2708 <br /> ENVIRONMENT HEALTH Telephone: (209)468-3420 Fax:(209)464-0138'Web: WWw-3j90v.vrg/ <br /> PERMITISERNES . PUBLIC RECO"S RELEASE AP'PLICA.TION <br /> APPLICANT: BUSINESS/AGENCY: <br /> ADDR> 55: CITYISTATEIZIF 94SC <br /> PHONE(1): ��rS"7�( (d J._�._.—pHoNE(2y: FACSIMILE: el 42 --'7V 6'.(00 9 � <br /> TENTATIVE"APPOINTMENT DATE: Time; <br /> (Please allow 10 business days from date of application submittal-'Tentafhre only-must be confirmed) <br /> In CHECK BOX TO Exp orm PrtQUEST.$105.00 FCE(CASH OR CHECK ONLY)-REGUEST PROCESSED IN 3 8PSiNESS DAYS <br /> DATE i7 <br /> SIGNATURE OF APPLICANT -- <br /> Electronic iniiormation: [3 List[]Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street Street Name city ❑ unit <br /> No <br /> ,, <br /> E1011nit 4 <br /> F2, <br /> f3. <br /> T. ❑ Unit 5 <br /> 8• 40ri <br /> Unit G <br /> 10. <br /> Specific Data Flange of Information Requested:From aL7CDjA to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERQROUND TANK(UST)CLEANUP S <br /> 'E(LOP) C7 HOUSING ABATEMENT OIJD WASTE FACILITYiYEHlCL6el�I • 3 <br /> HER CLEANUP SITE(NON-LL?P) c 0 FODn FACILITY ❑WASTeTME 1 <br /> NtrERL1RDUND TANK(MoNiTORINGlRELupVAL)V\ 0 DOG KUNNEL 0 DAIRY <br /> AZARDOUB WASTE GENERATOR 0 CHICKEN RANCH �YABTIaWATER TREATMENT PLAN <br /> Iml TIDO PERhATTED FAGiLIT`r ©MarWHDTFL PUWPFRTRUCKII'ARD(CHEMTOILSTs <br /> TATTOOBODY PIERCING 0 POOLISPA Cl LAND UsE APPLICATION SITES <br /> D MEDICAL.WAsm,,FACILITY n OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PolaT RECORD3ARE AVAILABLE FOR Rev1Ew-MONbAY-FRIOAY 8:00 Am-SAOPM - EXCLUDING HOLIDAY& <br /> 1. List ua t4tq <br /> a addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At Feast one file type MUST be selected. FaxAa(?,Q2)484-01:18 or ail td the add[e$s._it� Aabove. Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received atter <br /> 3:00 pm will be processed the next business day, <br /> 2. The EHD will notify the applicant if any iEHD files exist. An appointment for review Y411 be confirmed approximately teen(10) <br /> days after receipt of appi(catton. The Tiles will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new application may be <br /> submitted when the file is available, <br /> 4. Any file not retumed In the same condition as released will be reorganized by EHD staff at the expense of the applicant- <br /> Future file reviews by the same applicant may require a$105.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***If you heed further assistance plewe contact biane Moron= a (209)468.3425 directly. Thank You*** <br /> B�Aarmoe <br /> 46-06 <br />