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10/21/2004 16:12 FAX 209 9480 i 1@002 � <br /> ATE RECEIVED Q . . <br /> SAN JOAQUIN COUNTY Cf�+wa r.vman <br /> ENV R0NMNTAL$EALTEc DEPARTm-ENT <br /> 304 E Weber Ave 3`d Ploor Stockton,CA 95205 <br /> (209)458-34.20 Fax: (209)464-0139 Web:wwrw.co.san joaquin.mus/ehd <br /> OCT 2 1 2004EN 1 -PUBLIC RECORDS RELEASE A-PPLICAUON . <br /> �/�PPLI � �'_'�' .�[�a5'r/5 BUSINESSfAGIXCY: r�IE CJCJ <br /> ADDRESS: 02 rs� L d <br /> PHONE. FACSIMILF <br /> TENTATIVE'APPQtumm RATE: Time: !oZ►Z3, <br /> (Please allow 10 busirx=clays from date of applicadon submlttao <br /> CHECK BOX TO E]CF'Eorr"BEQUEST $91.00 FEE w REQUEST PROCIEUED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE s' <br /> Dem&mant Use Onto <br /> FILE A13ORESS UNtr <br /> 1. Suedao , <br /> 2. ne d unit 1 <br /> Unit 2 <br /> s. s� <br /> srrM a Unit 3 <br /> unit 4 <br /> n. Sam ' <br /> its <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(LIST)CL.FANUP SITE(LOP) In HOUSING ABATEMENT AL SOLID WASTE FACVLITY <br /> 4� OTH4R CLEANUP SITE(NPH-LOP) ❑ FOOD FACIL.rfY 0 SOLID WASTE VEICLE <br /> UNDERGROUND TANK(IMOWMR114GIREMOVAL) 0 DOC KENNEL IEL DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH ON-PKG TREATMENT PLANT <br /> Q TIERED PERMt7TED FACRJrY Q MOTEUMOTE1 TOIL <br /> =$ <br /> TRUCFCIYARDIGNE=Irl E1$ <br /> C7 <br /> Q TATirootBODY PIERGItYG © POOLJSPA la LUNO RE AFPLICATION SITES <br /> MEDICAL WASTE FACILITY CI OTHER(PLEASE SPECIFY] <br /> 1. list up tv tett addresses in the space above. Select the types) of files from the list aboye by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 208 464-0138 or mail to the <br /> address indicated above <br /> 2- EHD will notify the applicant if any END files exist An appointment for review will be con#irmed <br /> aPProXImAteiy five business days but no laterthan ten (10)days after receipt of a;pplicatton, The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> S- A file that is actively being worked on by EHD Staff May not be Immediately available for reYiew. A nev <br /> application may be submitted when the file is available. J <br /> 4• Any file not returned in the sanne 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 reviev <br /> 8. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Application's received after 3:00 pm will be processed the next business day. <br /> Mi`I].`i4I?POINTMENTTf AT ` <br /> ,Yc Mir <br /> 1ATE-CONF1Rl1A`1=p FAX `' : s. NrIALS' <br /> REVi,>=ytiftt[] YES NO RE11I> Nl RAT'~' <br /> EFIOIa-03�loe <br /> . lfOr1Q0.1 . <br />