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i <br /> Sent By: GEOCON CONSULTANTS; 1916 852 9132; Jun-24-04 9:25AM; Page 1I1 <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> JUN 2 4 2004 ENVIRONMENTAL, E DEPARTMENT <br /> !gypffl 304 E Weber Ave 34 Floor Stockton,CA 95205 <br /> R <br /> tiV�iII IJ VfJ1ENT 68-3420 Fax:(209)464-0138 Web: .vo.san;joaquin.cams/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAOE Y: I CIC 1k7[tik?ULL�'• T � � <br /> ADDRESS: 'x,11 v�? 1, �t N -L�I _ I �1 43 aC� X' C'r1�t�Lt A+C A► 9 �2 <br /> PHONE_ !'ak' �]� ^Q ! FACSIMILE ' ^38S2� c� <br /> r �j y 202 - <br /> TENTATtVE"APPOINTMENT DATE- 33 1179N, id 9-81 CA Time: <br /> (Pleas®silow 10 tiiisme s days from date of appowmion submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93:00 FEE—REQUEST ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE i*1= <br /> Dapettmenl Use Only <br /> r <br /> FILE AbESS UNIT <br /> 7R <br /> El Unit 1 �yJ� <br /> a. swee 11 Unit <br /> s. sa.e, c Unit 3 (­ <br /> 7. Ulm 4eunit 4 l/ <br /> e. scw+s <br /> ® Unit 5 y <br /> ID. saeec M _ <br /> 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ' J, <br /> It UNDERGROUND TANK(UST)CLEANUP SITE(LOP) [3HOUSING ABATEMENT SOLID WAS ;, r'• ' �I <br /> V OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY 9 SOLID WAS <br /> )a UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL, ❑ DAIRY n <br /> jt HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREAIVENT PLANT <br /> jim-neRED PMMMMD FACILITY C3 MOTEUHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TA17001BODY PIERCING ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY C7 OTHER(PLEASE SPECIFY <br /> 1. List up to ten addresses in the space above. Select the (s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 12091464.4138 or mail to the <br /> address indicated above. <br /> 2. END will notify the applicant if any END files st n appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after recelpt of application. The files <br /> will be held for a maximum of We business days for review. Appoln m rft should be scheduled <br /> accordingly. <br /> 3. A file that is actively being wonted on by END 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 reorpanixed by END 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 END staff. <br /> fi. Applications received atter 3:00 pm will be processed the next business day. <br /> GONFIRMED.APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITMS _ <br /> REVIEWED YES NO VIEW-DATER. V 5 <br /> laeo4a-02-0oe _ _. <br /> mere�aaa <br />