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0- 2004 .__14 50 4640138 ENVIROM ENTAL I-EALTH PAGE 01 <br /> EnU LW nUmoort <br /> 1� <br /> �AtflRl t tu"F9 i`J % I D SAN JOAQL7N COLNTX <br /> MAY 1 1 2004 E1NY1R01-iMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3r4 Floor Stockton,CA 93205 Ig/3 <br /> ENVIRONPAEPOWA! 1 (3420 Ftivax: (209)464-0138 Web: ww.co.sanjoaquiD.caus/ehd <br /> PERitiiIT/SERVICES <br /> 1PUBLIC RECORDS RELEASE APPtLICATIO'N <br /> APPLICANT: `C CO++ �I�Tlnrtrrl h c SUSMFss1AGENCf; 51rzr.s CrtVi/o Attan TV <br /> ADDRESS:_�35c/> 6I M&rInpc k lir ✓v'�- 5`]�y �aplt/s+�l &J-F Com- 9`W <br /> LPHONE:5� bT No` AQ&Z- FACSIMILE: <br /> TENTATIVE'`APPOINTMENT DATE: 00( Cali A!0 �O5�1frd✓�P Tme: 8:oa <br /> (Please allow to business days from data of application submittal) <br /> CHECK BOX TO EXPEDrtE REQUUrSTT-S93-000/F -y <br /> FEE-R£4t1EST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ! r `� � l.��� DATE 5/1.04 <br /> "� Department Un CnN <br /> RILE ADDRESS UNIT <br /> }01 5, W I 141 <br /> o� ❑ Un?t 1 <br /> ° <br /> P, <br /> seen! W a S�lw( Unit 2 <br /> a. srmel 3085 <br /> 1 <br /> S , S Unit 3 <br /> U <br /> e Sed <br /> o Unit 4 <br /> +. sueei <br /> a see <br /> 9. Skeet <br /> 70. Skee! <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑ HOUSING ABATEMENT C3 SOLID WASrE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) FpOD FACILITY ❑ SOLID WASTE VEHICLE <br /> OTHER CLfl.NUP SITE(NONLOP) ❑ DOG KENNEL fl PAMY <br /> h UNDERGROUND TANK(MONITORING/REMOVAL) CHICI�N RANCH n PKG TREATMENT PLANT <br /> HATARDOuS WASTE GENERATOR M MOTEVtIOT'EL ❑ PUMpr.RTRUCKlYARDICH'EM TOILETS <br /> ` C) TIERED PERMITTED FACKM pOO�PA b LAND USE APPllCATION SITES <br /> O TATTOO/anDY PIERCING P OTHER,(PLEASE SPECIFY) <br /> 1�O MEDICAL WASTE FACILITY <br /> 1. List up to ten addresses In the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2D8)464-0138 or mail to the <br /> address Indicated Dove. <br /> 2. EHD will notify,the applicant If any EHD fifes exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of appllcaSon. The flies <br /> will be held for a maximum of five business days for review. Appointments should be schoduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available far review. Anew <br /> application may be submitted when the file is available. at <br /> 4, Any file not returned in the same condition <br /> as 1 cant may req awill be �e a ized by E dDeposit prth OxPcr'50. <br /> of the applicant Future file reviews by the same app <br /> 5, <br /> *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 /> TIME <br /> CONFIPMED APPOINTMENT DATE INfI IA!S <br /> DATE CONFIRMED <br /> PHONE . FAX <br /> NO REVIEW DATE <br /> REYIcWED �� YES <br /> Eno as�ak6. _ <br /> 0/TO 39dd 3IIV3 ON snivd1S S0099L90ES 9t:4T b00Z/TT/S0 <br />