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Apr 23 2003 8:06RM s 4086860461 P.2 <br />46 0 <br />_ J <br />(�fl¢f2 1/ 963i11]� r0 _ 4640139 ENVIRANhENTAL HEAL*N PAGE 011 <br />I�1i t_: �• �_fiDl JOAQtliN Cou <br />.� <br />ENVIRONMENTAL. HEALTH DEPARTMENT <br />APR 2 3 2003 304 EAST WFEBER AVENUE, THIRD FLOOR <br />STOCKTON CA 95202 <br />ENV1R,.. tWPNT HEALTH (209) 4884420 1 05 <br />rpt AIT!c-Rtr;rcc PUBLIC RECORDS RELEASE APPLIICakricN <br />APPLICANT/j^tL.'EX L Lt -I'D BUSIXESSIAGENCv SvYYI M ► r- �_IN 4 /�j � a• -• •� <br />ADDRESS f Zq 00 A912&1 OQVb <br />PHONE RS VY -2 7 FACSIMILE-_ -_TSU 26L <br />TENTATr&" AppOMF' aNT DATE TIME — --- - -V (�/l / <br />(PIMNO give ?to 10 busirwas days from date ofeppFbation eul)m ttR►) <br />® CHECK BOX TO EXPEDrTE REQUEST • moo Pon -REQUEST PROCF_S3ED iN 3 BUSINF-33 DA:Y3 Uh <br />-` SIGNATURE OF APPLICANT "014a DATE D-- <br />10 <br />PIt.EADDRE99 ....� s.,.,.,..-. ..®G..... I <br />- PRacRAi�n ELr-aaEraT:e seARCH <br />0 <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br />OTHER CLEANUP SITE (NON•LOP) ❑ FOOD FACILITY ❑ SQL6E) WASTU'VEHIGLE <br />UNDERGROUND TANK (MONMORING REMOVAL) ❑ DOG KENNEL.. CI EW", <br />HAZARDOUS WASTE GENERATOR t7 CHECKEN RANCH ® FXG TREATMENT PLANT <br />❑ TIERED PSRMrrrED FACILITY 0 FAOTELJHOTEL ❑ FUNIPER TRUCKfYAR0/CHI1M T04LETS <br />❑ TATTOOIBODY PEIRGIN4 ❑ POOUSPA C7 LAND USP' APPLiCATION SiTES <br />n MEDICAL WASTE PACLITY 0 MIR (PLEASE SP'ECiFY) _ _ <br />1. List up to ten addresses in the space above. Select the type(s) of filer, from the Fist above by checking <br />the appropriate box(es). At least one file type MUST be selected. E 201202) L -Q13$ o n i tjle <br />address Indicated above. <br />2. EHD will notify the applicant if any EHD filen: exist. An appointment for rivArew will be confirmed <br />approximately five business days but no latar than ten (10) days after receipt of aPiAlcation. The fliam <br />will behold for a maximum of five business days for review. AppointrTmnts !hould be scheduled <br />accordingly. <br />3. A file that is actively being worked on by EHD staff may not be immediatniy a�+ailalk►le for re��levr. A now <br />application may be submitted when the file is available. <br />4. Any file not returned in the same condition as released will be reorgarlizr.4 by EIiID staff at 1he expen4e <br />of the applicant. Future file reviews by the same applicant may mquire 9i 1811.00 dlapOsit prior to rav,low. <br />b. *TENTATIVE appointment dates must be confirmed with EHD Staff. <br />6. Applications received after 3:00 pm will be processed the next busirmts qday. <br />asP, 13 1111 T 17M,r a <br />13ATE CONFOMED <br />Inme <br />PHONIS FAX <br />.rra*ra�,�rase11 <br />wr IALS <br />