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I. <br /> i Aui-09-04 21:43 From-TTI TETFc" H ESI INC +9188520307 ;`` T-017 P.01/02 F-227. <br /> DATE RECEIVED irND l-OG NUMBER <br /> r SAN JOAQUIN COUNTY <br /> ��E© ENVIRONMIENTAL MALTH DEPART1VfE T <br /> 304 F Weber Ave 3rd Floor Stockton;CA 9520 <br /> AUG 1 0 -2004(209)468-3420 Fax: (209)464-0135 Welt: www.co.s'=-joa4pi ca_uslehd i4b <br /> EN%jii iuiVMENT HEALTH <br /> �E PUBLIC RECORDS RELEASE AF'PLiCA. ION <br /> APPUCANT: ,TVral L. LaL 'z�) SUSINESSIAGENCY. Tl L GH [l <br /> ADDRESS: ( W t NC.kkO C.G'(L V <br /> PHONE, I S 53- 54 FACSIMI�: ( $152- 'Q <br /> TENTATIVE`APPOINTMENT DATE: r2Wv ? Time: edinlz <br /> ;I <br /> (Pique aitow 10 puniness days from date of applicauon suhml 1) <br /> M CROCK SOX TO WiR=TF RERUEST-493.N FEE—RFQUI;ST PROCESUD IN 3113INESS 0 YS <br /> SIGNATURE OF APPLICANT DATE d <br /> Deparn 1 use Only <br /> "DRESS `§ UNIT <br /> sacra, <br /> 7-7-7- E. 111E E .0,4 i~. c. 6TZ G!Lmi 1 k. <br /> x. unit 1 <br /> saaac � S. 9. c A <br /> � <br /> 9 Svnet 3 „I <br /> 31,5 <br /> �y[ Q unit 2 �`'� <br /> 4 5. J i�� <br /> _ C 4 / <br /> i. Snout4715 Ir. <br /> • B SvWc r� [ T C. C-s — YA`l�J�fYlr'11 <br /> r. Suaai 2 S. 7W 6 C 35 U <br /> a 3,_, U .9, G7I-A Acj c. <br /> s„ a M ¢-` AL-0. CA MhiU2ZrA35 / lr41n1t 5 <br /> ,o, street .7 0 3 !PTA �r c., 7Q G I 35 <br /> ENVIRONMENTAL HEALTH DEPARTMENt I-11-tZ. <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) M "GuSING A€IATFMENT '' 1D SO J0 WASTE FACILITY <br /> JOT"ER CLEANUP SITE(NON-LOP] IQ FOOD FACILITY M SO D WASTE VI:NICLE <br /> UNCI=RGROLIND TANK(MONITORINGrREMOvnL) 0 DOG K€NNEI DA RY <br /> HAZARDOUS WASTE GENFRATOR 0 CHiCKFN RANCH i C3 PK TREATMENT PLANT <br /> * TIERED PERMITTED FACILITY M M0TFunOTFI- � b PU PER TRUCKIYARRrCHF-M TOILETS <br /> Q TATTOOII3OPY PIERCING C3 POOUSPA ji M P U5E APPLICATION SITES <br /> la MEDICAL-WASTE FACILITY 13 OTHER(PLEASE SPFCIFY) <br /> 1. List up to teff addresses in the space above- Select the type{s}of files om the list above by cneckin9 <br /> the appropriate IYOX(es)• At[east one file type MUST be selected. Fax t 209 46+t-0938 or mail to the <br /> address indicated above. <br /> 2. EMP will notify the applicant if any EHD files exist. An appointment for eview will be confirmed <br /> approximately Five business days but no later than ten(7Q)[lays after r eipt of application. The files <br /> will be held for a maximum of five business days for review,' Appointme nts should be scheduled <br /> accordingly. <br /> 3. A file that is actively being wonted on by 1=Hp staff may not be immedia ely 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 reor,gana <br /> by Eflo staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require $93.00 deposit prior to review. <br /> 5. *TENTATIVE:appointment dates must be confirmed with EHp staff.' <br /> 6. Applications received after 3:00 pm will be processed the next bu;ines day- <br /> iit <br /> CONFIRMF-D APPCINTMF-NT DATE TIME: <br /> DATE CONFIRMED PHONI= FAX INITIALS <br /> r RE VIEWED YES NO REVKV1 ,PATE M <br /> 7tCROG3 - <br /> I <br />