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NOV. 16. 2004 11:20AM CONDOR EARTH TECH NO. 7885 P. 1 <br />\. DATE RECEIVED EHD LOG NUMBER <br />SAN JOAQVIN COUNTY <br />ENVIRONMENTAL HEALTlj. DEPARTMENT <br />304 E Weber Ave 3b Floor Stockton, CA 95205 <br />(209) 468-3420 Fax: (209) 464-0138 Web: www.co.sanjoaquin.ca.us/ehd <br />A I <br />PUBLIC RECORDS RELEASE AP/PLICATION-T 1 <br />APPLICANT: Ma-y'V.t", AtA'Qt &j BUSINESSIAGENCY: CbV�Y j-6-4- n tyLVUy�o�OgI Q.S/PKC. <br />ADDRESS: 156 Fi�nL 00_%4`fCorJe_ C+e. T.0SI-e�k�e.I,n� C.A jszog, <br />PHONE; 2.bf1-2-34-0518 FACSIMILE: 2091-2-S4-0153$ <br />TENTATIVE* APPOINTMENT DATE: 12 2 It 2(00'1 Tim: 12:007 AM tvA <br />(Pleaseallow70bualnessdaysfromdateofappllcaUonsubmittal) <br />CHECK BOX TO EXPEDITE REQUEST. $83.00FEE- REQU T PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT_�� <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />DATE I' Ila D q <br />anse menl UOn <br />P h <br />UNIT <br />1 <br />R❑k'Unit <br />ilUnit2 <br />(ff9 <br />Unit 3 <br />op"00,Unit 4 <br />❑ Unit 5 <br />W Q+ 10 <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT )E SOLID WASTE FACILITY <br />P5 THER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY d SOLID WASTE VEHICLE <br />W UNDERGROUND TANK (MONITORING/REMOVAL) O DOG KENNEL ZKbAIRY <br />JW HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH O PKG TREATMENT PLANT <br />TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br />TATTOWBODY PIERCING ❑ POOLISPA WLAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY CI OTHER (PLEASE SPECIFY) <br />1. list up to ten addresses In the space above. Select the type(s) of Tiles 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 mail 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 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 />3. A file that is actively being worked on by EHD staff may not be immediately 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 reorganized by EHD 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 />5. *TENTATNE appointment dates must be confirmed with EHD staff. <br />6. Applications received after 3:00 pm will be processed the next business day. <br />nAYi�"C•o,' � 'PPD N7f�Tl~fi(�'i'JA <br />NPIR„ ED: PFM, ttlftIAL <br />+vF a l <br />D.., i:,,,. <br />""ti�W tbW.�'dTE <br />EHO tB-02408 <br />NB2003 <br />