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—g,.,A .ta �,QQ,�d" ei 10• Anderson & ASSOC. y_z <br /> 1f�9 �U No•4226 Li"P 2 : .. <br /> D � <br /> SAN t.:OUNTY� <br /> FEB 17 2004 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton,,CA 95205 <br /> ENVIRONMENT I(INZfA68-3420 Fax: (209) 464-0138 Web: www.co.san-joaquin.ca.us/chd I <br /> PERMIT/SERVICES � <br /> yi\\ n PUBLIC RECORDS RELEASEAPPLIC//��ATION <br /> APPLICANT: p 79.A 2rtiGt v BUSINESSIAGE957,47- <br /> NCY: 46,k O - AYUe,,ys c�-A <br /> ADDRESS: I OZ- WVC,4A" W fn.�•t tLi "L1 S24Z ' <br /> PHONE: 5(2-4 -31p I FACSIMILE: "Nal E <br /> TENTATIVE'APPOINTMENT DATE: 3'2�0 T Time: Q 0.t\ <br /> i <br /> (Please allow 10 business days from.date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST- 93.00 FE -REQUEST PROCESSED IN 3 BUSINESS DAYS - <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> st.eet <br /> 331 W. Yore- Sk- City, �i `�1 p Unit <br /> 2. street 7-i JO (nOWS •Q4 rv1 1 rn�`- <br /> I street 223 W. 11)uS - 5:4 . City A. D 1 �: 0 Unit <br /> e. <br /> sveC 2\S (A). n?vt G Q. oZ <br /> s. street 93 m 1 a <br /> city V-'MA)D Unit 3 <br /> s. sv<a I Ole Z„d S•F . City <br /> steel a l)• ffif o Ayt Unit ) <br /> e. s,ree, x'33 LE- ►m�t,� s+ . Gl VM a <br /> 9. street 11 • 't14aAA � ' � .i M nl <br /> 10. sireel 3o4 ` ca CLk Acne- ou Eeon <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES } <br /> i <br /> 14 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT t ❑ SOLID WASTE FACILITY <br /> q OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> l!t UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL' ❑ DAIRY <br /> It HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑ PUMPER TRUCKIYARDICHEM TOILET: <br /> ❑ TATTOOBODY PIERCING ❑ POOLISPA ! ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY - ❑ OTHER(PLEASE SPECIFY) - <br /> 1. List up to ten addresses in the space above. Select the types) of files from the list above by checkil <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to thr <br /> address indicated above. <br /> 2. EHD will 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 file <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 r <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 expel <br /> of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to rev <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE IFAX INITIALS <br /> REVIEWED YES NO REVIEW DATE — <br /> EHD45-02-0 fi <br /> } <br />