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12/28/2003 18:38 925205121 AEI CONSULTANTS (SF) PAGE 01 <br /> - EHD.LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ]ENVIRONMENT-J''A.`!r AL HEALT)a DF PARTI�'1F'IVT <br /> i I '`: <br /> 304 E Weber Ave 34 Floor Stockton, CA 95205 <br /> 0 E C 3 .1 rte)468-3420 Fax: (209)4640138 Webs W-ww.cO.san-joaquuLca.us/ehd <br /> PUBLIC 'EC <br /> ORDS RELEASE A. PLICATI(lIV <br /> Yl C BUSi/NESSIAGErN,CY: <br /> APPLICANT: <br /> ADDRESS: <br /> C���� ✓ ��^�� �� " —FACSIMILE: <br /> PHONE: <br /> Time:. <br /> _& l2me: <br /> TENTATIVE*APPOINTMENT DATE: �' <br /> (Please allow 10 business days from date of applicatlon submittal) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$93.00 F E-REQUEST PROCESSED IN 3 BUSINESS DAYS �O ? <br /> DATE <br /> SIGNATURE OF APPLICANTDepartment Use OnIY <br /> i <br /> UNIT <br /> FILE ADDRESS <br /> 1. street ^( ,1�Je sor, fh a C� ❑ unit 1 <br /> - cAAl <br /> 2- Str I WLR G it lYl Unit 2 <br /> 3. W1 V_ <br /> 4; Street n Ott <br /> Unit 3 �(} � <br /> 5, Street Y�� G "� U <br /> G <br /> s. Strcot I i a Unit <br /> 7. Street 3A 11 1 we <br /> s ,. <br /> S. Street 2J 2-1 N, WE <br /> I <br /> 9. , Street <br /> 1k G <br /> 10. stca5t <br /> n Z W '�rr <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> SOLID WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) cl r000 FACIILSING BITY MENT Q SOLID WASTE VIEHICLE <br /> M OTHER CLEANUP SITE(NON-LOP) D DOG KENNEL ❑ DAIRY <br /> K UNDERGROUND TANK(MONITORINGyIREMOVAL) D CHICKEN RANCH !IL PKG TREATMENT PLANT <br /> 15k HAZARDOUS WASTE GENERATOR D MOTELIHOTEL ❑ PUMPER TRUCKlYARDICHEM TOILETS <br /> &) TIERED PERMITTED FACILn"YD POOLJSPA 9 LAND USE APPLICATION SITES <br /> d TATTootBODY PIERCING U OTHER(PLEASE SPECIM <br /> ❑ MEDICAL WASTE FACILITY <br /> 1, List up to ten addresses in the space aab®ve. elect be type(s) <br /> y acted f Fax too20S 4164-0gg$ist vorbma to thec <br /> the appropriate box(es). At least type <br /> address indicated above. <br /> 2. <br /> EHD will notify the applicant if any EHD files exist. An appointment nt o�g�e,p a alpPlication he files <br /> approximately five business days but no later than ten(10) y afterrreceipt <br /> should be scheduled <br /> will be held for a maximum of five business days for review. Appointments <br /> accordingly. <br /> $. A file that is actively being worked on by EHD staff may not be immediately available for review' <br /> rte. <br /> application may be submitted when the file is available. EHD staff at the experts <br /> 4. Any file not returned in the same condition as released will be reorganized <br /> a X93.00 deposit prior to revie <br /> of the applicant Future file reviews by the same applicant may req <br /> 5. *TENTATIVE appointment dates must <br /> b confirmed <br /> nfi rmed with EHD staff. <br /> the next business day. <br /> g. Applications received after 3:00 prP <br /> •RIME - <br /> NFIRMED.. '0iNTMtNT I5AT> l- <br /> C� Fes.. tNRlAti:S` <br /> DATE CONI=IRMEQ 'PHONE ' - <br /> NO REVIEW DATE I <br /> REVIEWED afES / <br /> EMD 45.02-000 - <br /> 8r8M001 <br />