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UNIT <br />El Unit 1 <br />Unit 2 <br />Unit 3 <br />Unit 4, <br />Unit 5 <br />FILE ADDRESS <br />airw2,IO S O re Ave cit, Loc i <br /> 61/eal U15 D S g 07 0 '1*. Ch 0 <br />3, SIMI ( 0 7-) 0 C41 troliqe. l_n • my Le, 1 <br />.1. s.,„, \ 1 53 I.) C. k_crol4 e c„... L-n. oat <br />8. atrao SP 5 2;ovv..er Pr , <br />6, ativet 1 0 ale rf71,Ce„e Lig • ci, Lod; <br />7 avw t ell 92 nAol_ PNe. . oh, 1,1) <br />a mak li O 1 5 k/C‘k‘e7 AS W • , My L-0 r; 1 <br />8- strum VaWa 1-)Qt-CIAIAS % ay ( _o <br />10. Sinai k kkk C 49 n 4" U n il (", I liCi cAy \--• 0 ,t( <br />K. <br />JUL. 13. 2004 2:04PM <br /> <br />NEWS SENTINEL <br /> <br />Na 3962 P. 2 <br />DATE RECEIVED <br />SAN JOAQUIN COUNTY <br /> EHD LOG NUMBEF <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E Weber Ave 3rd Floor Stockton, CA 95205 <br />(209) 468-3420 Fax: (209) 464-0138 Web: vvww.co.san-joaquin.ca.u.s/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: NA I CA) 011\e‘r BUS1NESS/AGENCY: C7 CA -C t4)7— <br />ADDRESS:1 91 C si (C1r1 : <br />PHONE: (0 0 7-JE7 FACSIMILE: (2? (4, - (0 -70& <br /> <br />TENTATIVE* APPOINTMENT DATE: lime: <br />(Please allow 10 buainaes days from data of application submittal) <br /> <br />CHECK BOX TO EXPEDITE REQUEST./ri.S9 0 FEE — T P4ROC ;...,,,,,7e6,,..4SSED IN 3 Et SINES'S DAYS <br />SIGNATURE OF APPLICANT (//,‘"7, -7 / 1 2 10 9 DATE <br />1301Vrtment Use Only <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES OLICIDOOD UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON-LOP) <br />UNDERGROUND TANK (MONITORING/REMOVAL) <br />HAZARDOUS WASTE GENERATOR <br />TIERED PERMITTED FACILITY <br />TATTOO/BODY PIERCING <br />MEDICAL WASTE FACILITY <br />HOUSING ABATEMENT <br />M FOOD FACILITY <br />CI DOG KENNEL <br />CHICKEN RANCH <br />IAOTELJHOTEL <br />U'r POOL/SPA <br />CI OTHER (PLEASE SPECIFY) <br />I: SOLID WASTE FACIUTY <br />CI SOLID WASTE VEHICLE <br />CI DAIRY <br />PKG TREATMENT PLANT <br />PUMPER TRUCK/YARD/CHEM TOILETS <br />C LAND USE APPLICATION SITES <br /> <br />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 (209) 464-0138 or mall to the <br />address indicated above. <br />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 than ten (10) days after receipt of application. The files <br />will be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly. <br />A file that Is actively being worked on by END staff may not be immediately available for review. A new <br />application may be submitted when the file is available. <br />Any file not returned in the same condition as released will be reorganized 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 />*TENTATIVE appointment dates must be confirmed with EHD staff. <br />Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX INITIALS <br />REVI5WEb , YES NO REVIEW DATE <br />END 40-02-006 <br />1. <br />ilfai2003