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_,BAKER & CRAMER, INC. PHONE NO. : 650 343 3967 Mar. 26 2004 09:23AM P2 <br /> EHD LOG NUMDER <br /> eAi,E I;ECEIVED J -,I SAN JOAQUIN COUNTY <br /> fLI L- = ENVIRONMEN'1'ALHEA1:17iDEPARTMF,NT <br /> MAR 2 6 2004 304 E Weber Ave 3rd Floor Stockton,CA 95205 e �� <br /> (209)468.3420 Fax: (209)464-0139 Web: www.co.sun-joaquin.ca.us/chd <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: _ _BUSINESSIAGENCY: r � <br /> PHONE: e B(1S � _...__.FACSIMILEA0 •j <br /> 3u - ' <br /> a Tlme: �C'A�H/• fit is . 1 <br /> TENTATIVEn POINTMENT PATE: '7 <br /> (Please allow 10 business days from date of apPllcatlon submetal) ''! ^r nLin n I <br /> CHECK BOX TO EXPEDITE REQUEST-593.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Dopartmonl Use Oniy <br /> FILE ADDRESS UNIT <br /> .,n':; t27Vb" WIA-1, rI ❑ Unll1 <br /> CRY <br /> ''' <br /> S. $Veal ,__- Cd Unit 3 /--I �„�,'1 <br /> 1. $VeN ..- eUnit4 <br /> a $1661 G <br /> TaT El Unit 5 <br /> 10, CImN Cr <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> p.UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> (OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> ❑ NDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL 13 DAIRY <br /> JQ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH O PKG TREATMENT PLANT <br /> =•(f,7F TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> TATTOOIDODY PIERCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY a 'OTHER(PLEASE SPECIFY�0��e���DiQ/�� <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 Tile type MUST be selected. Fax to (209)464-0136 Or mall 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 thariten(10)days after receipt of application. The files <br /> will be hold 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 now <br /> application may be submitted when the fife is available. <br /> 4. Any file not returned In the same condition as released iill be reorganized <br /> eor anizre a E 3A0 deposit it t theior o review.expense <br /> of the applicant. Future file reviews by the same app <br /> 5. '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.APPOINTMENT DATETIME - <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> _ta,_ ...._. ._. —_..- <br /> NR00] <br />