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04/05/2004 09:27 9252836121 AEI CONSULTANTS (SF)_ <br />t)� c vED SANJOAQMN CCUU1`1')GY <br />\4 04 ENvxRoNmmNTA LJ�EaLTH ]DEraP. rr�r <br />APR 0 7 20 3041✓ WeberAve 3 Floor Stockton, CA 95205 <br />(�,09) 458-3420 Fax: (209) 464-0138 Web: vAw.co.san-joaquin.caus/e'hd <br />PEMMIT/� : PUBLIC RECORDS PELEASE APPLICATION <br />APPLICANT: 11W _ , <br />ADDRESS: <br />BUSINESWAGENCY: -Yi <br />PAGE 01 <br />EHD LOG N <br />Im <br />PHONE: �I� 2b -'s- (RQ2FACSIMILE: AL 126-6 U 12'1 <br />TENTATIVE* APPOINTMENT DATE: �i / 1 Time: <br />A <br />(Please allow 10 business days from date of application sttbrtittta!) A <br />CHECK BOX TO EXPEDITE REQUEST - $93.00 FEE – REQUEST PROCESSED IN 3 BUSINESS DAYS I v <br />SIGNATURE VMA <br />h, /04 <br />OF APPLICANT <br />DATE <br />Department Use Only <br />�. <br />FILE ADDRESS <br />UNIT <br />17 <br />o -,i �L �1 <br />�-0 W0111 SC le iliavu„ <br />2 Sntee! '7 <br />G <br />Unit 1 <br />�^ <br />3. SCeet 0 S. @ mora <br />-111 <br />Ci <br />Unit 2 <br />tt <br />a. Str=t Ce(*- .t <br />5. street i J �. <br />— 7�Ov3h r s 41�21YeA <br />6. snot i 0 5, GI Doff <br />a 1' <br />Fnit4 <br />u <br />a ask <br />20 4 <br />t`APR9 <br />-sca <br />Unit 5 <br />ia. street <br />G <br />ENVIRONMENTAL. <br />HEALTH DEPARTMENT <br />FILES <br />UNDERGROUND TANK (UST) CLEANUP 511E (LOP) 13 HOUSING ABATEMENT <br />XSOLIOWASTE <br />OTHER CLEANUP SITE (NON -LOP) <br />❑ FOOD FACILITY <br />4 SOLID WASTE VEHIGtI`'E v <br />UNDERGROUND TANK (MONITORINGIRHMOVAL) ❑ DOG KENNEL <br />❑ DAIRY <br />HAZARDOUS WASTE GENERATOR <br />❑ CHICKEN RANCID <br />9 PKG TREATMENT PLANT <br />$ TIERED PERMITTED FACILITY <br />C3 MOTELINOTEL <br />Cl PUMPER TRUCWYARD/CHEM TOILETS <br />�j TATTOO/BODY PIERCING <br />❑ POOL1SPA <br />AL LAND USE APPLICATION SITES <br />C3 MEDICAL WASTE FACILITY <br />❑ OTHER (PLEASE SPECIFY] <br />1. List up to ten addresses In the space above. Select the type(s) of files from the list above ay checking <br />the appropriate box(es). At least one file type MUST be selected. Fax to 1209) 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 $93.00 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPoiNrMENT I1ATE - :.'1ME <br />"PKONI*:. 'FAQIN1TfALS�Lf :•=�` = <br />REVIEWED YES NO REVIEW DATE <br />EHD 4$-=-M <br />8144M <br />