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�y�-J•+•' 11-25-0.3; 1 :OOPM;CRA STOCKTON ;209 983 6960 _ # 2, <br /> 11/25/2003 12:13 4G4013 1 <br /> _ . ENVIRQNf+1ENTAL Hf,�ff-i MAGI= 01 <br /> l MMU L",L 1V 1 <br /> UlVIOMI <br /> iro" tE,RECEIv�;o._! 1L_-n! SAN JOAQUIN COUNTY <br /> NOV 2•.v. 2003 ENVIRONMENTAL HEALTH)DEPARTMENT <br /> r 304 E Weber Ave 3`4 Floor Stockton, CA 95205 57q <br /> `�PJVi�1.iI�P1� i i l i )4G8_3420 Fax. (209)464-0138 Web; www.co.sau joaquin.cams/ehd <br /> P �jkjIT/SFPNIC. l <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPucANT: CO�U�S�jOe--7�} -�V�` S �� ' <br /> BUSINESSIAGENCY: I <br /> I <br /> 202 Vft 7De 1 w 7 r� <br /> DRESS: p <br /> X91 NONE: rzO q" __bK_ 6 -�1 D FACSIMILE: 2'0-!^ 9 s <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> j (Plesse allow 10 business days from date of application 9ubmtttal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93-00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNAtURE OF APPLICANT DATE <br /> Department Use only <br /> FILE ADDRESS UNIT �,� <br /> ,. street o L w G ❑ unit 7 h� <br /> -( ci ❑ unit 2 �� ? <br /> G. 51re nrw -!� <br /> 16. 31re, ty <br /> If Ctnnit4 <br /> G. Street � <br /> 7. Street <br /> ia- Strom c� <br /> j ❑ Urllt <br /> 9. Slra+ci <br /> city <br /> 19. street <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES 'i <br /> I <br /> �UNOERGROUND TANK(UST)CLEANUP SITE(LOP) d HOUSING ABATEMENT 13 SOLID WASTE FACILITY <br /> Z� THER CLEANUP SITE(NON-LOP) In FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK EMfl PKO TREATMENT PLANT <br /> OWTORINGIROVAL} ❑ DOG KENNEL CI DAIRY <br /> ❑ CHICKEN RANCH �C� <br /> Cl HAZARDOUS WASTE GENERATOR ❑ MOTEtJHOTEL ❑ PUMPER TRUCKIYARDIcHEM TOILE <br /> ❑ TIERED PERMITTED FACILITY NN t p p t1SE APPLICATION SITES <br /> 13 TATTOO/DODY PIERCING ❑ P OUlSPA _4 <br /> Q MEDICAL WASTE FACILITY THER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Seloct the type(s) of files from the list above by checkinf <br /> the appropriate box(es). At least one file type MUST bd selected. Fax to209 464.0138 or mail to the <br /> address indicated above. <br /> 2, EHD w111 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. AppointmOnts'should be scheduled <br /> accordingly. <br /> 3. Afile that is actively being worked on by EHD staff may not be immediately available for review. Ane <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 t <br /> of the applicant. Future file reviews by the same applicant may require a l <br /> re e 1 <br /> 5. I?a <br /> *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> g, Applications received after 3:00 pm wilt be processed the next business day. <br /> CONFIRMED APpoINTMENT DATE TIME ------------- <br /> PHONE FAX INITIALS <br /> DALE CONFIRMED _,. .__... <br /> REVIEWED YES No REVIEW DATE <br /> ' EHDdB�2�G8 <br /> erartans <br />