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DATE RECEIVED • • EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`d Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web: www.co.san-joaquin.ca.us/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> mp, <br /> APPLICANT: Damrell, Nelson, Schri <br /> _ Kathy L. Monday BUSINESS/AGENCY: Pallios, Pacher & Silva <br /> ADDRESS: 1601 I Street, Fifth Floor. Modesto California 95354 <br /> PHONE: (209) 526-3500 FACSIMILE: (209) 526-3534 <br /> TENTATIVE*APPOINTMENT DATE: February 10, 2004 Time: 9:30 a.m. <br /> (Please allow 110 business days from date of application submittal) <br /> ED CHECK BOX TO EXPEDITE REQUEST- 93 0 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT itleix- e /ate DATE January 22, 2004 <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> t. street 1601 Turnpike city Stockton <br /> 2. street city ❑ Unit 1 <br /> 3. Street Cit <br /> 4. StreetCil E] Unit 2 <br /> 5. Street Cay <br /> 6. street cit ❑ Unit 3 <br /> 7. Street city <br /> ❑ Unit 4 <br /> e. so-eet cit <br /> 9. street city ❑ Unit 5 <br /> m. seeet ci <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NZ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> ❑ UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> In TATTOO/BODY PIERCING ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 7. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the <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 files <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 new <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 expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <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 FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 4342A06 <br /> 8(612003 <br />