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AUG-23-2004 15:51 CWR EARTH TECH 209 532 0773 P.01/0: <br /> DATE RECEIVED, - EHD LOG NUI R <br /> E l <br /> r„(�yP_ X�'� I 1 SANJOAQiIi1�I COMIiTy <br /> �P, EN vMONMENTAL RFALTH DEPARTMENT <br /> AUG 3 2004 304 E Weber Ave 3''Floor Stockton, CA 95205 <br /> j Hj2'�%468-3420 Fax. (209) 464-0138 Web: www,CO.saD joaquin.Ca-us/ehd <br /> ENVIRONI�EN t PUBL'C RECORDS RELEASE APPLICATION <br /> lqbo7 — <br /> GRMITISERVICES ��'' <br /> APPLICANT:_ O;TS'u ( yi:; A1Z-.&�I3USINESWA,GENCY: nib R EM LMrHAjot <br /> ADDRESS:L!- Cq) �R <br /> PHON �v ( � 1 ..-' Q-�(j�� FACSIMILE!.-16 <br /> TENTATIVE'APPOINTMENT DATE T1me: <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-P3,00 -•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 6 <br /> Department Use OnN <br /> FELE ADDRESS <br /> UNIT <br /> z see t CRY „ ❑ Unit 1 <br /> 3. seg a 00 4 <br /> 4Tri UnR2 <br /> � , <br /> s. sv.d a fi E Unit 3 ,j 5 <br /> 7. so-.« 5 12R.• U51 /� Unit4 '! <br /> a sum 0 L ca <br /> a. so-. a 11LZ aES <br /> to, sve„ E n� OGKTO ❑ Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES a <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT <93• SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) LI FOOD FACILITY *r SOLID WASTE VEHICLE <br /> QS, UNDERGROUND TANK(MONITORNGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> $► TIERED PERMITTED FACILITY ❑ MOTEIIHOTEL d PUMPER TRUCK/YARDICHEM iou-M <br /> ❑ TATTOOISODYPIERCING Cl POOL/SPA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY D OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(z) of files from the list above by cheddn <br /> the appropriate box(es). At least one file type MUST be selected. Fatl_to (209) 46"138 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 ne <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 expens <br /> Of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to revie <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after3:00 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 /> TOTAL P.O: <br />