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09'/27/20174 16 1� FAX,209 8480 3 r 002 <br /> --- �' _ SAN JOAQUm COUNTY <br /> E+NVIRONMENTAL HEALTH DEPARTMENT <br /> 304E Weber Ave 31d Floor Stockton,CA 95205 <br /> S EP 7 200&09)46$-3420 Fax: (204)454-0138 Web:*ww.co.san-joaquin.c&us/ehd � <br /> ENV4RG y"dig iv ILF'�T PUBLIC RECORDS RELEASE APPLICATION <br /> S � <br /> APPL1CArial: 'PrA+ - 13USINMAGEHCY: <br /> PHONE: �� l�ytiFACSIMILE.. <br /> TENTATIVE'APPVINTt ENT DATE: 1 7 M <br /> (Please allow 10 business days fiwn data of appricion submittal) <br /> 13 CHECK BOX TO EXPEDI'T'E REQUEST 493.00 FEE- REQUEST PROCI=SSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 9 cf-Y <br /> Deoaftent Use ONY <br /> y.•f1FILE ADDRESS UNIT <br /> N i. sucee RZO E&It- V40L& "Z l t_ ❑ Unit 1 <br /> 3. sftwt A9A a4l- 7,1- q-&_ .1 OA Unit 2 <br /> 2 4 4 i� 011 Q�d'�t. h- CRI . A <br /> y !` ill) aH Unit 3 I <br /> 6. S4dx <br /> 7, sweet Chv <br /> 8. <br /> 9. 34edic <br /> CRY - n t� <br /> to. secs My9 <br /> •ETMRONMENTAL HEALTH DEF ARTMENT FILES x r <br /> UNDERGROUND TANK(VST)CLEMUP SI'T'E(LOP) r3 HOUSING ABATEMENT SL SOLID WASTE FACUTY <br /> OTHER.CLEANUP SITE(NON-LOP) <br /> FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> ® UNDERGROUND TANK WONITORINGIREMOVAL) Q DOG KENNEL DAIRY <br /> 1!a HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH Mi.-pKG TREATMENT PLANT <br /> E3 TIERED PERMITTED FACILITY 0 MOTELIHOTEL T] PUMPERTRUCK/YARDICHEM TOILETS <br /> Q TATTOOf60DY YIERGING I M LAND USE AP LICATION SITES <br /> Q POOLrPA <br /> 0 MEDICALWASTE FACILITY 6E OTHER(PLEASE SPEC" <br /> 1. List up to ton addresses in the space above.Select the type($)of flies from the list aboye by checking <br /> the appropriate box(es), At least one file type MOST tie selected. Fax to 209 46", 138 or mall to the <br /> address indicated above. <br /> 2. EHD Will notify the applicant if any EHD files.exist Art 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. Appolotments 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. Anew <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 21t the expense <br /> of the applicant. Future file reviews by the scree appiiCant may require a$93.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHO staff. <br /> B. Applications received after 3:00 pmwill be processed the next business day. <br /> TIME <br /> aCt�N�I.I�ME:D`f�?�oINT�l�ri�'tlA��'1 =�••;r.�;' ,_. .- — - _ . �=_ • <br /> 3Ji4Tlr CONF�R1Vl1r[] ''`kPIiONE . FAX <br /> 'i <br /> R1=YlE1Nn -., YES Nb REVIEW MATE' i <br /> Eiv 44-0z94e <br /> arartoos . . <br />