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11/26/2003 11:32 916-786-0366 LFR PAGE 02/E <br /> ►7.AJ.`I J v.li�UliV L l.a U 1�1 <br /> ENVIRONNxENTAL REALTH DEPA.RTMEIv'x <br /> 304 E Weber Ave 3'a Floor Stockton, CA.95205 <br /> (209 468.3420 Fax: (209)464-0138 Web:www.co.san-joaquirLca_us/ehd <br /> NOV 2 6 2003 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> rPn ��n7 -�/Q i <br /> APPLICANT:� ��4� BUS1NE851AGENCY: <br /> ADDRESS: 4- c7^ �OyG L �7g z;,!e-v-D SL'17 r~ c� Grg Ar/T>r L'1 ��� �S% <br /> BONE: 9i6 - 7 g 6 - 7✓6`� FACSIMILE: <br /> 9/5 - 7 85- - 0365 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Phase allow 10 bualness days frbM date of rppiiCatibn sUbmlttq <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-RE ROC tl9 3 13USiNESS DAYS 'L <br /> *11�IGNATVRE OF APPLICANT - C --�� DATE <br /> Detrartment Use Or <br /> FiLE ADDRESS UNIT <br /> k,�err city 55 p Unit i <br /> 2. suM+ 4 �- 70� 2 cc.GN-r r'.�. C; <br /> S. sn+d d p Unit 2 <br /> A. City <br /> $I" 2ty PR5 Q <br /> 7. s,�l <br /> a <br /> a. sre� <br /> OTY <br /> ENVIRONMENTAL HEALTH VEPARTMENT FILES <br /> UNDERGROUND TANK(U91)CLEANUP$ITE(LOP) ❑ HOUSING ABATEMENT O $OLID WASTE FACILITY <br /> �S OTHER CLEANUP SrM(NON-LOP) ❑ FOOD FACILITY G SOLID WASTE VEHICLE11lC UNDERGROUND TANK(MONMORINGfREMOVAL) 0 DOG KENNEL ❑ DAIRY . <br /> L1 HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH O PKI;TREAT14 EM PLANT <br /> M TIERED PERMITTED FAMTY 0 MOTE1MOT91. M PUMPER TRUCK1YARDICHEM TOW ) <br /> D TATTOO/BODY PIERCING D POOLISPA ❑ LAND USE APPLICATION SrITS <br /> M 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 by cheel 9 <br /> the appropriate box(es). At least one file type MUST be selected. 'Fax_to(209)464-0138 or mail to t <br /> address indicated above. <br /> 2. 1;HD will notify the applicant if any END 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 fi <br /> will be held for a maximum of five business days for review. Appointments!Should be schedulad <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A N <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 expo , e <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to m v. <br /> 5. `TENTATIVE appointment dates must be conflrrned with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. - . <br /> F <br /> ED APPOINTMENT DATE TIME <br /> IRMED PHONE FAX INrrlALS <br /> YES NO R1~111EW DATE <br /> EMO 49-04.Oa6 _ <br /> NSRUDS , <br />